经皮微波消融治疗良性甲状腺结节的疗效分析

Efficacy Analysis of Percutaneous Microwave Ablation for Benign Thyroid Nodules

目的:探讨经皮微波消融治疗良性甲状腺结节的疗效。方法:选取2018年1月-2018年12月,到我院就诊的122例良性甲状腺结节患者为研究对象,均接受经皮微波消融治疗并于术后1个月、3个月返院复查,比较122例患者术前、术后1个月、术后3个月超声下结节变化及影像学表现、症状评分及美观评分、并发症发生情况。结果:术后1个月、3个月患者的结节平均最长径分别为(1.97±0.44)cm、(1.69±0.50)cm,均明显低于术前(t_(1)=14.417、t_(2)=17.247,P<0.001);术后1个月、3个月患者的结节平均体积分别为(1.43±1.20)cm^(3)、(1.00±0.90)cm^(3),均明显低于术前(t_(1)=8.626、t_(2)=9.261,P<0.001);术后1个月、3个月患者的症状评分分别为(1.57±0.94)分、(0.62±0.18)分,均明显低于术前(t_(1)=13.348、t_(2)=24.839,P<0.001);术后1个月、3个月患者的美观评分分别为(1.73±0.64)分、(1.12±0.33)分,均明显低于术前(t_(1)=14.414、t_(2)=23.857,P<0.001);术后1个月术区结节体积明显缩小,接近结节吸收消散期时,术区呈均匀低回声,结节内部及周边无血流信号,无严重并发症,仅有27.87%的患者在术后1个月颈部有轻微不适,均可自行缓解。结论:经皮微波消融治疗良性甲状腺结节疗效显著,术后症状改善明显且短期内便可缩小结节体积,恢复正常颈部外观,同时术后并发症发生较少,安全性良好,建议推广。

Objective:To investigate the efficacy of percutaneous microwave ablation in the treatment of benign thyroid nodules.Methods:The study period was from January to December 2018.The subjects were 122 patients with benign thyroid nodules who were treated in our hospital.They all received percutaneous microwave ablation and returned to the hospital for reexamination 1 month and 3 months after operation.The changes,imaging manifestations,symptom scores,aesthetic scores and complications of 122 patients under ultrasound before operation,1 month and 3 months after operation were compared.Results:The average longest meridians of nodules at 1 and 3 months after operation were(1.97±0.44)cm and(1.69±0.50)cm respectively,which were significantly lower than those before operation(t_(1)=14.417,t_(2)=17.247,P<0.001).The average nodule volume at 1 month and 3 months after operation were(1.43±1.20)cm^(3) and(1.00±0.90)cm^(3) respectively,which were significantly lower than that before operation(t_(1)=8.626,t_(2)=9.261,P<0.001).The symptom scores at 1 month and 3 months after operation were(1.57±0.94)and(0.62±0.18)respectively,which were significantly lower than those before operation(t_(1)=13.348,t_(2)=24.839,P<0.001).The aesthetic scores at 1 month and 3 months after operation were(1.73±0.64)and(1.12±0.33)respectively,which were significantly lower than those before operation(t_(1)=14.414,t_(2)=23.857,P<0.001).One month after operation,the volume of the nodule in the operation area was significantly reduced,and the operation area showed uniform hypoechoic when close the nodule absorption and dissipation period.There was no blood flow signal inside and around the nodule,and no serious complications.Only 27.87%of the patients had slight discomfort in the neck one month after operation,which could be relieved by themselves.Conclusion:Percutaneous microwave ablation is effective in the treatment of benign thyroid nodules.The postoperative symptoms are significantly improved.It can reduce the nodule volume and restore the normal neck appearance in the short term.At the same time,there are fewer postoperative complications and safe.It is recommended to be popularized.