不同直径甲状腺良性结节患者应用US-RFA治疗的疗效及安全性研究

Efficacy and safety of US-RFA treatment for patients with benign thyroid nodules of different diameters

目的探讨不同直径甲状腺良性结节患者应用超声引导下射频消融(US-RFA)治疗的疗效及安全性。方法选择2020年1月至2022年6月中山陈星海中西医结合医院收治的50例行US-RFA治疗的患者作为研究对象。50例患者共80个甲状腺良性结节,根据直径大小分为A组18例(直径<2cm,30个)、B组20例(直径≥2cm且<4cm,32个)和C组12例(直径≥4cm,18个)。比较三组患者结节消融后1个月、3个月、6个月、12个月的结节体积减小率以及术前和术后12个月外观自测评分、症状评分;同时比较三组患者的并发症发生率。结果术后6个月、12个月,A组患者的结节体积缩小率分别为(73.53±20.52)%、(83.18±17.22)%,明显高于B组的(68.92±14.23)%、(79.26±14.28)%和C组的(57.53±17.02)%、(70.03±14.35)%,且B组高于C组,差异均具有统计学意义(P<0.05);术后12个月,B组患者的外观自测评分、症状评分分别为(1.71±0.52)分、(1.52±0.44)分,明显低于C组的(2.08±0.66)分、(2.23±0.57)分,差异均有统计学意义(P<0.05);A组、B组、C组患者的并发症发生率分别为5.56%、5.00%、8.33%,差异无统计学意义(P>0.05)。结论不同直径甲状腺良性结节患者应用US-RFA治疗的疗效确切,消融疗效评估时间节点可选术后6个月,初始结节直径≥2cm(B组+C组)的患者外观自测评分、症状评分有明显改善,初始结节直径<4cm(A组+B组)的患者体积有明显缩小;甲状腺结节消融治疗并发症发生率低,安全可靠。

Objective To explore the efficacy and safety of ultrasound-guided radiofrequency ablation(US-RFA)for patients with benign thyroid nodules of different diameters.Methods Fifty patients who received US-RFA treatment at Zhongshan Chenxinghai Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to June 2022 were selected as the research subjects.According to the diameter of the nodules,the 50 pa-tients(with a total of 80 benign thyroid nodules)were divided into group A(18 cases,with a diameter of<2 cm,30 nod-ules),group B(20 cases,with a diameter of≥2 cm and<4 cm,32 nodules),and group C(12 cases,with a diameter of≥4 cm,18 nodules).The reduction rate of nodule volume at 1 month,3 months,6 months,and 12 months after nod-ule ablation among three groups of patients were compared,as well as the appearance self-test score and symptom score before and 12 months after surgery.The incidences of complications were compared among the three groups of patients.Results At 6 and 12 months after surgery,the reduction rates of nodule volume in group A were(73.53±20.52)%and(83.18±17.22)%,which were significantly higher than(68.92±14.23)%,(79.26±14.28)%in group B and(57.53±17.02)%and(70.03±14.35)%in group C;the reduction rates in group B were significantly higher than those in group C;the differences were statistically significant(P<0.05).At 12 months after surgery,the appearance self-test scores and symptom scores in group B were(1.71±0.52)points and(1.52±0.44)points,which were significantly lower than(2.08±0.66)points and(2.23±0.57)points in group C(P<0.05).The incidences of complications in group A,group B,and group C were 5.56%,5.00%,and 8.33%,with no statistically significant difference(P>0.05).Conclusion The efficacy of US-RFA treatment for patients with benign thyroid nodules of different diameters is definite,and the evaluation of ab-lation efficacy can be conducted at 6 months after surgery.Patients with initial nodule diameter≥2 cm(group B+group C)showed significant improvement in appearance self-test score and symptom score,while patients with initial nodule diameter<4 cm(group A+group B)showed significant reduction in volume.US-RFA for patients with benign thyroid nodules is safe and reliable,with low incidences of complications.