超声引导下射频消融甲状腺微小乳头状癌疗效评估

Evaluation of the Efficacy of Ultrasound-guided Radiofrequency Ablation of Papillary Thyroid Microcarcinoma

目的:探讨超声引导下经皮射频消融治疗甲状腺微小乳头状癌的效果。方法:选择60例甲状腺单灶微小乳头状癌患者,均接受超声引导下经皮射频消融治疗;治疗后使用超声造影对消融情况进行评估,在治疗后1、3、6、12个月对消融区域体积及甲状腺功能进行检测,同时对患者进行临床评估。结果:随访1、3、6个月后消融区域逐渐缩小,每2次随访间差异有统计学意义(P<0.05);治疗后1、3、6个月肿瘤组织的体积缩小比(VRR)逐渐增加,每2次随访之间的VRR差异均有统计学意义(P<0.05);治疗前后患者甲状腺功能相关指标差异无统计学意义(P>0.05);随访过程中未发现肿瘤局部复发、远处转移等情况;术后最常见并发症为轻微疼痛,共22例,占比36.67%(22/60),部分患者存在牙痛、单侧头痛等症状,术后24~48 h所有疼痛症状消失,无需治疗。结论:对单灶性甲状腺微小乳头状癌采用超声引导下经皮射频消融治疗安全有效,并发症发生风险较低,同时能够保留甲状腺功能,适用于不符合手术指征患者。

Objective:To investigate the effect of ultrasound-guided percutaneous radiofrequency ablation in the treatment of papillary thyroid microcarcinoma.Methods:A total of 60 patients with single focal thyroid papillary carcinoma were treated with ultrasound-guided percutaneous radiofrequency ablation.After treatment,contrast-enhanced ultrasound was used to evaluate the ablation.The size of the ablation area and thyroid function were detected 1,3,6,12 months after treatment,and the patients were evaluated clinically.Results:The ablation area gradually narrowed after 1,3,6 months of follow-up.He difference between each two follow-up visits was statistically significant(P<0.05).The volume reduction ratio(VRR)of the ablation area gradually increased at 1,3,6 months after treatment,and the VRR difference between each two follow-up visits was statistically significant(P<0.05).There was no significant difference between the thyroid function test results before and after treatment(P>0.05).No local recurrence and distant metastasis of the tumor were found during the follow-up.The most common complication after the operation was mild pain,with 22 cases in total,accounting for 36.67%(22/60).Some patients had symptoms such as toothache and unilateral headache.All the pain symptoms disappeared 24~48 hours after the operation,and no treatment was needed.Conclusion:Ultrasound-guided percutaneous radiofrequency ablation is safe and effective in the treatment of papillary thyroid microcarcinoma,with a low risk of complications,while retaining thyroid function.It is suitable for patients who do not meet the surgical indications,and is worthy of clinical application.