微波消融术与传统切除手术治疗甲状腺良性结节的临床疗效

Clinical efficacy of microwave ablation and traditional resection in the treatment of benign thyroid nodules

目的探讨微波消融术与传统切除手术治疗甲状腺良性结节的临床疗效。方法选取2018年1月至2020年12月上海市公惠医院收治的200例甲状腺良性结节患者作为研究对象,采用随机数字表法分为对照组与观察组,每组100例。对照组采用传统手术,观察组采用微波消融术,比较两组临床疗效、手术前后甲状腺激素[血清游离三碘甲状腺素(FT_(3))、游离四碘甲状腺素(FT_(4))及促甲状腺激素(TSH)]、应激激素[血清去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(CORT)]水平、并发症发生情况。结果两组临床总有效率比较差异无统计学意义。术前,两组血清FT_(3)、FT_(4)、TSH水平比较差异无统计学意义;术后1个月,两组血清FT_(3)、FT_(4)水平均低于术前,TSH水平均高于术前,但观察组血清FT_(3)、FT_(4)水平均高于对照组,TSH水平低于对照组,差异有统计学意义(P<0.05)。术前,两组NE、E、CORT水平比较差异无统计学意义;术后24h,两组血清NE、E、CORT水平均高于术前,但观察组均低于对照组,差异有统计学意义(P<0.05)。术后1个月,观察组并发症发生率为1.00%,低于对照组的8.00%,差异有统计学意义(P<0.05)。结论微波消融术治疗甲状腺良性结节患者与传统手术相比疗效相当,可有效避免机体过度应激反应,术后并发症发生情况明显较少,减轻对甲状腺功能的损伤。

Objective To investigate the clinical effect of microwave ablation and traditional resection in the treatment of benign thyroid nod-ules.Methods 200 patients with benign thyroid nodules treated in Shanghai Gonghui Hospital from January 2018 to December 2020 were selected as the study subjects,and they were divided into the control group and the observation group according to random number table method,with 100 cases in each group.The control group underwent traditional surgery,and the observation group underwent microwave ablation,the clinical efficacy,thyroid hormone(serum free triiodothyroxine[FT_(3)],free tetraiodothyroxine[FT_(4)]and thyrotropin[TSH]),stress hormone(serum norepinephrine[NE],epinephrine[E],cortisol[CORT])levels before and after surgery and complications were compared between the two groups.Results There was no significant difference in total effective rate between the two groups.Before surgery,there were no significant differences in the serum FT_(3),FT_(4)and TSH levels between the two groups.1 month after surgery,the levels of serum FT_(3)and FT_(4)of the two groups were lower than before surgery,and the level of TSH was higher than before surgery,but the levels of serum FT_(3)and FT_(4)in the observation group were higher than those in the con-trol group,and the level of TSH was lower than that in the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant difference in NE,E and CORT levels between the two groups;24 h after surgery,the levels of serum NE,E and CORT of the two groups were higher than before surgery,but the observation group was lower than the control group,the differences were statistically significant(P<0.05).1 month after surgery,the incidence of complications in the observation group was 1.00%,which was lower than 8.00%in the control group,and the difference was statistically significant(P<0.05).Conclusions Compared with traditional surgery,microwave ablation is effective in the treatment of patients with benign thyroid nodules,it can effectively avoid the excessive stress reaction of the body,and the incidence of postoperative complications is obviously less,so as to reduce the damage to thyroid function.