超声引导下刺穿囊壁消融治疗甲状腺良性囊实性结节的效果

Curative effect of ultrasound-guided puncture cystic wall ablation on thyroid benign cystic solid nodules

目的探讨超声引导下刺穿囊壁消融治疗甲状腺良性囊实性结节的效果及对结节体积、并发症发生率的影响。方法回顾性分析我院在2016年1月—2021年1月期间收治的102例甲状腺良性囊实性结节患者作为研究对象,根据手术方式分为刺穿囊壁消融组57例和无水酒精注射(PEI)组45例,刺穿囊壁消融组给予超声引导下刺穿囊壁消融治疗,PEI组给予PEI治疗。术后对两组患者良性囊实性结节缩小率进行比较,术前及术后采用全自动生化仪对两组患者血清中甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)水平进行检测,术前及术后采用酶联免疫吸附实验(ELISA)对两组患者血清中白细胞介素6(IL-6)、C-反应蛋白(CRP)水平进行检测,术后,统计两组患者并发症情况。结果术后2个月,刺穿囊壁消融组患者结节缩小率明显高于PEI组(P<0.05);术后1个月,刺穿囊壁消融组患者血清中FT3、FT4水平明显高于PEI组,且TSH水平明显低于PEI组(P<0.05);术后1 d,刺穿囊壁消融组患者血清中CRP、IL-6水平均明显低于PEI组(P<0.05);术后1个月,刺穿囊壁消融组患者并发症总发生率明显低于PEI组(P<0.05)。结论与PEI相比声引导下刺穿囊壁消融治疗可以促进结节体积缩小、改善甲状腺功能、降低炎性因子水平和并发症。

Objective To explore the curative effect of ultrasound-guided puncture cystic wall ablation on thyroid benign cystic solid nodules and its influences on nodules volume and incidence of complications.Methods A retrospective analysis was performed on the 102 patients with thyroid benign cystic solid nodules admitted to the hospital from January 2016 to January 2021.According to different surgical methods,they were divided into puncture cystic wall ablation group(57 cases,ultrasound-guided puncture cystic wall ablation)and percutaneous ethanol injection(PEI)group(45 cases,PEI).The reduction rate of benign cystic solid nodules between the two groups was compared after surgery.Before and after surgery,levels of serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3)and free thyroxine(FT4)in both groups were detected by full-automatic biochemical analyzer.Before and after surgery,levels of serum interleukin-6(IL-6)and C-reactive protein(CRP)in both groups were detected by enzyme-linked immunosorbent assay(ELISA).After surgery,postoperative complications in both groups were statistically analyzed.Results At 2 months after surgery,the reduction rate of nodules in puncture cystic wall ablation group was significantly higher than that in PEI group(P<0.05).At 1 month after surgery,the levels of serum FT3 and FT4 in puncture cystic wall ablation group were significantly higher than those in PEI group(P<0.05),and the TSH level was significantly lower than that in PEI group(P<0.05).At 1d after surgery,the levels of serum CRP and IL-6 in puncture cystic wall ablation group were significantly lower than those in PEI group(P<0.05).At 1 month after surgery,total incidence of complications in puncture cystic wall ablation group was significantly lower than that in PEI group(P<0.05).Conclusion Compared with PEI,ultrasound-guided puncture cystic wall ablation can promote reduction of nodules volume,improve thyroid function,reduce levels of inflammatory factors and complications.