术前风险评估在甲状腺良性结节行超声引导微波消融术中的应用价值分析

The value of preoperative risk assessment in ultrasound-guided microwave ablation of benign thyroid nodule

目的 探讨分析术前风险评估在甲状腺良性结节行超声引导微波消融术中的应用价值。方法 选取解放军总医院收治的340例甲状腺良性结节患者为研究对象。依据随机数字表法将患者分为观察组和对照组各170例。对照组患者在微波消融术进行治疗中仅使用“液体隔离带法”对周围组织进行隔离保护,观察组患者依据术前风险评估分级采用不同的预防保护措施进行微波消融治疗。结果 观察组患者短期并发症发生率为8.8%(15/170),低于对照组的24.1%(41/170),而术后恢复满意度评价观察组满意率为95.3%(162/170),高于对照组的81.2%(132/170),差异均有统计学意义(均P<0.05);观察组血清hs-CRP、TNF-α表达分别为(8.67±3.19)、(4.28±1.25),均低于对照组的(14.64±6.76)、(11.59±5.12),差异均有统计学意义(均P<0.05);术后第6个月,观察组结节平均容积缩减率为(83.57±10.50)%,明显高于对照组的(74.33±12.13)%;观察组并发症发生率为6.50%(11/170),明显低于对照组16.50%(28/170);术后第12个月,观察组结节平均容积缩减率为(94.02±8.08)%,高于对照组的(85.14±7.19)%,观察组并发症发生率为2.40%(4/170),明显低于对照组7.60%(13/170),以上比较差异均有统计学意义(均P<0.05)。结论 对甲状腺良性结节患者行微波消融术前进行风险评估,并合理使用预防保护措施,有助于提高结节平均容积缩减率,并降低术后并发症发生率。

Objective To investigate the application value of preoperative risk assessment in patients with benign thyroid nodules treated by ultrasound-guided microwave ablation.Methods A total of 340patients with benign thyroid nodules were selected as the research objects,which were divided into observation group and control group,170cases in each,randomly.“Hydrodissection”was only applied to the control group to prevent the adjacent vital structures from thermal injuries,while different preventive and protective measures were applied to the observation group.Results The incidence of short-term complications in the observation group was 8.8%(15/170),lower than 24.1%(41/170)in the control group,while the satisfaction rate of the postoperative recovery in the observation group was 95.3%(162/170),higher than 81.2%(132/170)in the control group,with significant statistical difference(all P<0.05).The serum hsCRP and TNF-αexpressions of the observation group were(8.67±3.19)and(4.28±1.25),respectively,lower than those of the control group(14.64±6.76and 11.59±5.12),with significant statistical difference(all P<0.05).At the6th month after operation,the average volume reduction rate of the observation group was(83.57±10.50)%,which was significantly higher than that of the control group[(74.33±12.13)%],and the complication rate of the observation group was 6.50%(11/170),which was significantly lower than that of the control group(16.50%,28/170),with significant statistical difference(all P<0.05).At the 12th month after operation,the average volume reduction rate of the observation group was(94.02±8.08)%,which was significantly higher than that of the control group[(85.14±7.19)%],and the complication rate of the observation group was 2.40%(4/170),which was significantly lower than that of the control group(7.60%,13/170),with significant statistical difference(all P<0.05).Conclusion Assessing the risk before microwave ablation in patients with benign thyroid nodules and using preventive measures wisely can help to improve the mean volume reduction rate of nodules and reduce the incidence of postoperative complications.