微波消融术在甲状腺良性结节中的治疗效果及对FT_(3)、FT_(4)水平的影响

Effect of Microwave Ablation on Benign Thyroid Nodules and Its Influence on FT_(3) and FT_(4) Levels

目的:探讨微波消融术(MWA)在甲状腺良性结节(BTN)中的治疗效果及对游离三碘甲腺原氨酸(FT_(3))和游离甲状腺素(FT_(4))水平的影响。方法:选取2020年6月-2021年6月景德镇市第一人民医院收治的100例BTN患者为研究对象,按照随机数字表法分为对照组和研究组,各50例。对照组采用常规切除术治疗,研究组采用MWA治疗。比较两组临床疗效、围手术期指标、甲状腺激素水平[促甲状腺激素(TSH)、FT_(3)、FT_(4)]、并发症发生情况。比较研究组手术前后的结节体积及术后不同时间点的结节缩小率。结果:研究组总有效率为90.00%,高于对照组的74.00%,差异有统计学意义(P<0.05);研究组手术时间及住院时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);术后1、3、6、12个月,研究组结节体积不断缩小,结节缩小率越来越高,差异均有统计学意义(P<0.05);术后6个月,研究组TSH水平低于对照组,FT_(3)和FT_(4)水平均高于对照组,差异均有统计学意义(P<0.05);研究组并发症发生率为4.00%,低于对照组的16.00%,差异有统计学意义(P<0.05)。结论:BTN患者采用MWA治疗可缩短手术时间和住院时间,改善患者甲状腺功能,减少并发症发生,安全性高,值得推广。

Objective:To investigate the effect of microwave ablation(MWA)on benign thyroid nodules(BTN)and its influence on free triiodothyronine(FT_(3))and free thyroxine(FT_(4))levels.Method:A total of 100 patients with BTN admitted to Jingdezhen First People’s Hospital from June 2020 to June 2021 were selected as the research objects and divided into control group and study group according to the random number table method,with 50 cases in each group.The control group was treated with conventional resection,and the study group was treated with MWA.The clinical efficacy,perioperative indicators,thyroid hormone levels[thyroid stimulating hormone(TSH),FT_(3),FT_(4)]and the incidence of complications between the two groups were compared.The nodule volumes before and after the operation and the nodule reduction rates at different time points after the operation were compared in the study group.Result:The total effective rate of the study group was 90.00%,which was higher than 74.00%of the control group,the difference was statistically significant(P<0.05).The operation time and hospital stay of the study group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,the differences were statistically significant(P<0.05).At 1,3,6 and 12 months after surgery,the nodule volume in the study group continuously decreased,and the nodule reduction rate became higher and higher,the differences were statistically significant(P<0.05).6 months after surgery,the level of TSH in the study group was lower than that of the control group,and the levels of FT_(3)and FT_(4)were higher than those of the control group,the differences were statistically significant(P<0.05).The incidence of complications in the study group was 4.00%,which was lower than 16.00%in the control group,the difference was statistically significant(P<0.05).Conclusion:MWA therapy in patients with BTN can shorten the operation time and hospital stay,improve thyroid function of patients and reduce complications,and it has high safety,with worthy of promotion.