两步法在单纯性甲状腺囊性结节伴出血硬化治疗中的临床应用价值

Clinical application value of two-step puncture in ultrasound-guided sclerotherapy of simple thyroid cyst with hemorrhage

目的评价两步法在超声引导下单纯性甲状腺囊性结节伴出血硬化治疗中的临床应用价值。方法纳入2019—2021年于南京市中医院超声科行甲状腺结节穿刺治疗的患者47例。传统治疗组对单纯性囊性结节伴出血患者仅进行超声引导下抽液+硬化治疗术;两步法是在传统超声引导下抽液+硬化治疗基础上,治疗术后3~4 d,再次对囊腔内渗出液进行单纯抽液治疗。术后1周、1、3、6个月观察囊肿变化情况和并发症。结果传统治疗组临床治愈率为57.9%,术后1周,术后1、3、6个月后,囊肿缩小率分别为:44.1%,65.5%,76.3%,83.2%,术后6个月复发率68.4%;两步法治疗组临床治愈率为96.4%,术后1周,术后1、3、6个月后,囊肿缩小率分别为:60.4%,81.7%,91.8%,95.4%,术后6个月复发率降为25.0%。结论两步法可以明显减少囊肿复发率,增加囊肿缩小率,加速囊肿吸收的进程,而不增加患者的任何不良反应,是一种更好的治疗方法,值得临床推广使用。

Objective To evaluate the clinical value of ultrosound by guided two-step method in the treatment of simple cyst of thyroid gland hemorrhage.Methods From 2019 to 2021,47 patients with thyroid gland cyst were enrolled.In the traditional treatment group,the simple cyst of the thyroid gland hemorrhage was treated with liquid drainage and sclerotherapy under the guidance of ultrasound.The two-step method was based on the traditional ultrasound-guided liquid drainge and sclerotherapy,the intracavity exudate was again extracted 3~4 days after the treatment.The changes and complications of the cyst were observed in 1 week,1 month,3 months and 6 months respectively after surgery.Results In the traditional treatment group,the clinical cure rate was 57.9%.After 1 week,1 month,3 months and 6 months,the reduction rate of cysts were 44.1%,65.5%,76.3%and 83.2%respectively.The recurrence rate was 68.4%after surgery.The clinical cure rate of the two-step method group was 96.4%.The reduction rate of cyst were 60.4%,81.7%,91.8%and 95.4%respectively.The recurrence rate was 25.0%in 6 months after surgery.Conclusion The two-step method can significantly reduce the recurrence rate of cyst,increase the reduction rate of the cyst and accelerate the process of cyst absorption,without increasing any adverse reactions in patients.It is a better treatment method which is worthy of clinical promotion.