超声引导下微波消融与开放手术治疗甲状腺良性结节对术中出血量、激素水平及并发症的影响

Effects of ultrasound-guided microwave ablation and open surgery on intraoperative blood loss,hormones and complications in patients with benign thyroid nodule

目的分析超声引导下微波消融与开放手术治疗甲状腺良性结节(BTN)对术中出血量、激素水平及并发症的影响。方法选取150例BTN患者,采用随机数字表法分为微波消融组(超声引导下微波消融术)和开放手术组(开放手术),各75例。比较两组BTN患者手术一般情况、术后结节清除率和术前和术后1周血清游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺激素(TSH)水平及并发症发生率。结果微波消融组手术时间、切口长度、术中出血量、术后引流量和住院时间均低于开放手术组,差异均有统计学意义(t分别=23.30、46.88、49.11、11.79、32.02,P均<0.05);术后1周,微波消融组血清TSH水平低于开放手术组,FT_(3)和FT_(4)水平高于开放手术组(t分别=-3.41、4.78、6.32,P均<0.05);微波消融组术后并发症发生率为9.33%,低于开放手术组的21.33%,差异有统计学意义(χ^(2)=4.16,P<0.05)。结论与开放手术比较,超声引导下微波消融术可减少BTN患者术中出血量,改善术后甲状腺激素水平,降低并发症发生率。

Objective To explore the effects of ultrasound-guided microwave ablation and open surgery on intraoperative blood loss,hormones and complications in patients with benign thyroid nodule(BTN).Methods A total of 150 patients with BTN were enrolled and divided into microwave ablation group(ultrasound-guided microwave ablation)and open surgery group(open surgery)according to random number table method,with 75 cases in each group.The general operation,postoperative nodule clearance,serum levels of free triiodothyronine(FT_(3)),free thyroxine(FT_(4))and thyroid stimulating hormone(TSH)before surgery and 1 week after surgery,and the incidence of complications were compared between the two groups.Results The operation time,incision length,intraoperative blood loss,postoperative drainage volume and hospitalization time in microwave ablation group were lower than those in open surgery group(t=23.30,46.88,49.11,11.79,32.02,P<0.05).At 1 week after surgery,level of serum TSH in microwave ablation group was lower than that in open surgery group,while levels of serum FT_(3) and FT_(4) were higher than those in open surgery group(t=-3.41,4.78,6.32,P<0.05).The incidence of postoperative complications in microwave ablation group was lower than that in open surgery group(9.33%vs 21.33%,χ^(2)=4.16,P<0.05).Conclusion Compared with open surgery,ultrasoundguided microwave ablation can reduce intraoperative blood loss,improve postoperative levels of thyroid hormones and reduce the incidence of complications in BTN patients.