超声引导下微波消融与传统甲状腺手术治疗甲状腺良性肿瘤的疗效及对甲状腺功能的影响

Ultrasound Guided Microwave Ablation and Traditional Thyroid Surgery for the Treatment of Benign Thyroid Tumors and Their Effects on Thyroid Function

目的探讨对甲状腺良性肿瘤患者采用超声引导下微波消融术与开放式甲状腺手术治疗的效果差异及对甲状腺功能的影响。方法选取该院2020年1—12月收治的甲状腺良性肿瘤患者90例,按照随机数表法分为开放式甲状腺手术治疗对照组(n=45)与采用超声引导下微波消融治疗研究组(n=45),比较两组临床疗效以及手术相关指标(手术时间、出血量、住院时间),检测两组治疗前后甲状腺激素(FT3、FT4、TSH)水平评价患者甲状腺功能变化,并统计两组并发症情况分析治疗安全性。结果研究组治疗总有效率93.33%,高于对照组77.78%;并发症发生率2.22%,低于对照组17.78%,差异有统计学意义(χ^(2)=4.406、4.444,P<0.05)。研究组手术时间、出血量、住院时间分别为(36.82±6.74)min、(14.10±3.20)mL、(4.32±1.02)d,均小于对照组;治疗后研究组FT3、FT4水平分别为(5.90±0.29)pmol/L、(16.23±1.20)pmol/L,高于对照组;TSH水平为(2.14±0.24)mU/L,低于对照组,差异有统计学意义(t=13.136、18.815、17.194、13.365、20.145、13.313,P<0.05)。结论对甲状腺良性肿瘤采用超声引导下微波消融术治疗效果理想,对患者的损伤小,术后恢复快,对甲状腺功能的影响小,可降低并发症发生率。

Objective To investigate the effect of ultrasound-guided microwave ablation and open thyroid surgery for patients with benign thyroid tumors and their impact on thyroid function.Methods From January to December 2020,90 patients with thyroid benign tumors were selected from the hospital.According to the random number table,they were divided into an open thyroid surgery treatment control group(n=45)and an ultrasound-guided microwave ablation treatment study group(n=45),compared the clinical efficacy and surgical-related indicators(operating time,blood loss,length of hospitalization)between the two groups,detect the levels of thyroid hormones(FT3,FT4,TSH)before and after treatment in the two groups to evaluate the changes in thyroid function of the patients,and counted the two groups of complications and treatment safety.Results The total effective rate of treatment in the study group was 93.33%,which was higher than 77.78%in the control group;the complication rate was 2.22%,which was lower than 17.78%in the control group.The difference was statistically significant(χ^(2)=4.406,4.444,P<0.05).The operation time,blood loss,and hospitalization time of the study group were(36.82±6.74)min,(14.10±3.20)mL,and(4.32±1.02)d,respectively,which were less than those of the control group.After treatment,the levels of FT3 and FT4 in the study group were(5.90±0.29)pmol/L,(16.23±1.20)pmol/L,higher than the control group;TSH level(2.14±0.24)mU/L,lower than the control group,the difference was statistically significant(t=13.136,18.815,17.194,13.365,20.145,13.313,P<0.05).Conclusion Ultrasound-guided microwave ablation for benign thyroid tumors has an ideal therapeutic effect,with little damage to patients,quick recovery after surgery,and little impact on thyroid function.It can reduce the incidence of complications.