射频消融术与无水乙醇联合射频消融术治疗甲状腺囊实性结节的效果对比分析

Comparative analysis of efficacy of radiofrequency ablation and anhydrous ethanol combined with radiofrequency ablation in treatment of cystic and solid thyroid nodules

目的比较超声引导下经皮射频消融术(radiofrequency ablation,RFA)与无水乙醇联合射频消融术(anhydrous ethanol combined with radiofrequency ablation,EA+RFA)治疗甲状腺囊实性结节的效果。方法回顾性分析2019-05—2020-12郑州大学第一附属医院甲状腺外科收治的227例甲状腺囊实性结节患者的临床资料。按治疗方式分为射频消融组(RFA组,118例)和联合消融组(EA+RFA组,109例)。多发结节以体积最大者计。治疗后随访6个月,比较2组的有效性和安全性。结果术后1个月时,EA+RFA组患者的甲状腺结节体积缩小率大于RFA组,差异有统计学意义(P<0.05);术后3个月、6个月时,结节体积缩小率差异无统计学意义(P>0.05)。术后6个月时,2组患者的结节体积缩小率均值>60%,2组消融治疗均有效。术后1、3、6个月时,2组患者间不同囊占比对术后甲状腺结节体积缩小率差异无统计学意义(P>0.05)。2组术后并发症发生率均较低且差异无统计学意义(P>0.05)。结论对良性甲状腺囊实性结节患者实施RFA或EA+RFA消融,效果确切且安全性好,其中EA+RFA短期内甲状腺结节缩小速度更理想。但2种方法的长期应用效果仍需今后开展多中心、前瞻性研究证实。

Objective To compare the therapeutic effects of ultrasound-guided percutaneous radiofrequency ablation(RFA)and anhydrous ethanol combined with radiofrequency ablation(EA+RFA)in treatment of cystic and solid thyroid nodules.Methods The clinical data of 227 patients with cystic and solid thyroid nodules admitted to Thyroid Department of the First Affiliated Hospital of Zhengzhou University from May 2019 to December 2020 were retrospectively analyzed,and they were divided into two groups according to different treatment methods.Among them,the radiofrequency ablation group(RFA)118 cases,combined ablation group(EA+RFA)109 cases.Multiple nodules are are based on the largest volume.Follow-up for 6 months after treatment.The efficacy and safety were compared between the two groups.Results At 1 month after surgery,the volume shrinkage rate of thyroid nodules in the EA+RFA group was greater than that of the RFA group,and the difference was statistically significant(P<0.05).There was no significant difference in the shrinkage rate at 3 and 6 months after operation(P>0.05).At 6 months after operation,the mean nodule volume shrinkage rate in the two groups was more than 60%,and the ablation treatment in both groups was effective.At 1,3,and 6 months after surgery,there was no significant difference in the volume shrinkage rate of thyroid nodules between the two groups with different proportions of cysts(all P>0.05).In terms of safety,the incidence of postoperative complications in both groups was lower and the difference was not statistically significant(P>0.05).Conclusion RFA or EA+RFA ablation is effective and safe in patients with benign thyroid cystic and solid nodules.Among them,EA+RFA has a better short-term shrinkage rate of thyroid nodules,but the long-term application effect of the two methods still needs to be confirmed by multi-center and prospective studies in the future.