微波消融联合无水乙醇治疗囊性甲状腺结节临床疗效观察

Clinical observation of microwave ablation combined with anhydrous ethanol in the treatment of cystic thyroid nodules inical

目的观察囊性甲状腺结节选择微波消融联合无水乙醇的治疗效果。方法回顾性选取2019年1月至2019年12月于南京市中医院甲乳外科行超声引导下甲状腺囊性结节(最大径≥2cm)消融术56例患者。按照消融方法不同分为微波消融联合无水乙醇组和微波消融组。其中微波消融联合无水乙醇组36例,微波消融组20例,比较两组治疗后甲状腺结节的体积缩小率、术后并发症发生率、甲状腺功能改变情况。采用SPSS 21.0进行统计学分析,以均数±标准差(x±s)描述统计量,行t检验;计数资料采用率(%)表示,行χ^(2)检验,以P<0.05为差异具有统计学意义。结果微波消融联合无水乙醇组与微波消融组在术后3个月结节体积缩小率为(49.86±6.78)%vs(22.84±1.88)%;术后6个月为(67.57±5.84)%vs(47.25±7.09)%;术后12个月为(75.70±4.51)%vs(71.14±4.65)%;差异有统计学意义(P<0.001)。两组术后并发症发生率分别为38.89%vs 45.00%,差异无统计学意义(P>0.05),且所有并发症均在2个月内痊愈。两组术前及术后12个月甲状腺功能(T3、T4、FT3、FT4、TSH)的差异无统计学意义(P>0.05)。结论微波消融联合无水乙醇对治疗囊性甲状腺结节与单用微波消融治疗相比有更好的临床效果,对缓解患者症状、缩小结节体积等方面有明显优势,且不影响甲状腺功能,临床上可作为治疗囊性甲状腺结节的推荐选择方案。

Objective To observe the therapeutic effect of microwave ablation combined with anhydrous ethanol for cystic thyroid nodules.Methods From Jan.2019 to Dec.2019,56 patients with thyroid cystic nodules(≥2cm)underwent ultrasound guided thyroid cystic nodule ablation in Department of Thyroid and Breast Surgery,Nanjing Hospital of Traditional Chinese Medicine.According to different ablation methods,the patients were divided into microwave ablation combined with anhydrous ethanol group and microwave ablation group.There were 36 cases in microwave ablation combined with anhydrous ethanol group and 20 cases in microwave ablation group.The volume reduction rate of thyroid nodules,the incidence of postoperative complications and the changes of thyroid function were compared between the two groups after treatment.Statistical analysis were performed using SPSS,version 21.0,the mean±SD deviation(x±s)was used to describe the statistics,t-test was performed,and the adoption rate of counting data(%)was expressed byχ^(2) test.The difference was statistically significant with P<0.05.Results The nodule volume reduction rates of the microwave ablation combined with anhydrous ethanol group and microwave ablation group were(49.86±6.78)%vs(22.84±1.88)%,(67.57±5.84)%vs(47.25±7.09)%and(75.70±4.51)%vs(71.14±4.65)%at 3 months,6 months and 12 months after operation,respectively.There was significant difference between the two groups(P<0.001).The incidence of postoperative complications in the two groups was 38.89%and 45.00%respectively,and there was no significant difference between the two groups(P>0.05),and all complications were cured within 2 months.There was no significant difference in thyroid function(T3,T4,FT3,FT4,TSH)between the two groups before and 12 months after operation(P>0.05).Conclusions Microwave ablation combined with anhydrous ethanol is more effective in treatment of cystic thyroid nodules(≥2cm)than microwave ablation alone.It can significantly improve patients’symptoms and nodule volume reduction,and does not affect thyroid function.It can be used as a recommended option for treatment of cysticthyroid nodules.