超声引导下微波消融甲状腺微小乳头状癌的临床研究

Clinical study on ultrasound-guided microwave ablation of papillary thyroid microcarcinoma

目的:分析超声引导下微波消融治疗甲状腺微小乳头状癌(PTMC)的疗效。方法:选取2022年5月—2023年1月于德宏州人民医院接受超声引导下微波消融治疗的50例PTMC的患者进行跟踪随访调查,分别在术前及术后1、3、12个月对其甲状腺功能进行评估,统计消融灶吸收及病灶转移情况。结果:治疗后患者并发症情况统计发现,有2例局部疼痛患者,但在第2天有所缓解,其余并发症例数为0。术前促甲状腺素、三碘甲状原氨酸、游离甲状腺素浓度分别为(2.95±1.83)μIU/mL、(3.22±0.57)pg/mL、(0.84±0.21)ng/dL,消融术后1个月分别为(2.98±1.62)μIU/mL、(3.20±0.61)pg/mL、(0.93±0.12)ng/dL,比较差异无统计学意义(P>0.05)。术前病灶体积为(78.22±49.57)mm^(3),与术后1、3、12个月的病灶体积(115.44±42.44)mm^(3)、(31.42±24.43)mm^(3)、(0.53±2.98)mm^(3)比较,差异有统计学意义(P<0.05);术后1个月与术前病灶体积比较,差异有统计学意义(t=4.033,P<0.05);术后1、3、12个月病灶体积缩小率分别为(-88.24±58.64)%、(69.72±22.45)%、(99.88±2.55)%,差异有统计学意义(P<0.05)。结论:微波消融术在PTMC治疗方面表现出有效性、安全性,治疗效率高,值得进一步推广应用。

Objective To analyze the efficacy of ultrasound-guided microwave ablation in the treatment of papillary thyroid microcarcinoma(PTMC).Methods 50 patients with PTMC who received ultrasound-guided microwave ablation treatment at Dehong Prefecture People's Hospital from May 2022 to January 2023 for follow-up investigation were selected.Thyroid function was evaluated before and 1,3,and 12 months after surgery,and the absorption and metastasis of the ablation lesion were statistically analyzed.Results After treatment,it was found that there were 2 patients with local pain,but there was some relief on the 2nd day,and the number of other complications was 0.Before surgery,the concentrations of thyroid stimulating hormone,triiodothyronine,and free thyroid hormone were(2.95±1.83)μIU/mL,(3.22±0.57)pg/mL,and(0.84±0.21)ng/dL,respectively.One month after ablation,the levels of thyroid stimulating hormone,triiodothyronine,and free thyroid hormone were(2.98±1.62)μIU/mL,(3.20±0.61)pg/mL,and(0.93±0.12)ng/dL,respectively,with no statistically significant difference(P>0.05).The preoperative lesion volume was(78.22±49.57)mm^(3),while the postoperative lesion volumes at 1 month,3 months,and 12 months were(115.44±42.44)mm^(3),(31.42±24.43)mm^(3),and(0.53±2.98)mm^(3),respectively,with statistical significance(P<0.05).There was a statistically significant difference(t=4.033,P<0.05)between one month after surgery and before surgery.The reduction rates of lesion volume at 1 month,3 months,and 12 months after surgery were(-88.24±58.64)%,(69.72±22.45)%,and(99.88±2.55)%,respectively,with significant difference(P<0.05).Conclusion Microwave ablation has shown effectiveness,safety,and high treatment efficiency in the treatment of PTMC,and is worthy of further promotion and application.