射频消融术治疗甲状腺功能亢进的安全性及有效性

Safety and efficacy of radiofrequency ablation for hyperthyroidism

目的 探讨超声引导下射频消融术治疗甲状腺功能亢进症(甲亢)的安全性及有效性。方法 选取厦门医学院附属第二医院2018年7月—2019年6月确诊为甲亢并进行超声引导下射频消融术(radiofrequency ablation, RFA)的患者27例。对比消融术前后甲状腺体积大小、总三碘甲腺原氨酸(TT_(3))、游离三碘甲腺原氨酸(FT_(3))、总甲状腺素(TT_(4))、游离甲状腺素(FT_(4))、促甲状腺激素(TSH)、临床症状及并发症情况。结果 与消融术前比较,患者术后临床症状明显改善(P<0.05),术后3、6和12个月甲状腺体积明显变小(P<0.05),术后血清TT_(3)、TT_(4)、FT_(3)、FT_(4)等水平显著降低(P<0.05),TSH显著升高(P<0.05)。并发症声音嘶哑的发生率为3.7%,心动过速的发生率11.1%,治疗后均恢复,且未再复发,无其他并发症。结论 超声引导下经皮射频消融术治疗甲亢安全有效,能明显改善患者症状,且并发症较少。

Objective To explore the safety and efficacy of ultrasound-guided radiofrequency ablation(RFA) in the treatment of hyperthyroidism. Methods Twenty-seven patients with hyperthyroidism from The Second Affiliated Hospital of Xiamen Medical College in the period of July 2018 to June 2019 were treated with ultrasound-guided RFA.Thyroid volume, total triiodized thyroid hormone(TT_(3)), free triiodized thyroid hormone(FT_(3)), total tetriodized thyroid hormone(TT_(4)), free tetriodized thyroid hormone(FT_(4)), thyroid stimulating hormone(TSH), clinical symptoms, and complications were compared before and after RFA. Results The clinical symptoms of patients were significantly improved after surgery(P<0.05). The thyroid volumes were significantly reduced 3, 6, 12 months after surgery(P<0.05). Serum TT_(3), TT_(4), FT_(3), and FT_(4) levels decreased significantly and TSH increased significantly after surgery(P<0.05). The hoarseness rate reached 3.7% and tachycardia rate reached 11.1%, which all recovered after treatment without recurrence and no other complications occurred. Conclusion Ultrasound-guided percutaneous RFA is a safe and effective method for hyperthyroidism, which can improve the symptoms significantly with few complications.