超声引导下微波消融联合无水乙醇硬化治疗甲状腺囊实性结节的效果

Effect of ultrasound-guided microwave ablation combined with absolute ethanol sclerotherapy in the treatment of thyroid cystic-solid nodules

目的探讨超声引导下微波消融(UGMA)联合无水乙醇硬化治疗甲状腺囊实性结节的效果。方法队列研究。抽取2021年8月至2023年8月郑州人民医院收治的甲状腺囊实性结节患者56例,按随机数字表法分为硬化组(28例)和UGMA组(28例)。UGMA组采用UGMA治疗,硬化组采用UGMA联合无水乙醇硬化治疗。比较两组结节体积缩小率、应激反应指标[甲肾上腺素(NE)、皮质醇(COR)]、甲状腺功能[甲状腺刺激抗体(TSAb)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]及并发症发生率。结果术后1、3、6个月,硬化组结节体积缩小率高于UGMA组(P<0.05),术后1个月,硬化组NE、COR水平低与UGMA组(P<0.05)。术后1个月,硬化组TSAb、FT4水平低于UGMA组,TSH水平较高(P<0.05);硬化组并发症发生率(10.71%,3/28)与UGMA组(17.86%,5/28)比较差异未见统计学意义(P>0.05)。结论UGMA联合无水乙醇硬化治疗甲状腺囊实性结节效果显著,能促进结节缩小,改善机体应激反应和甲状腺功能,且治疗安全性较高。

Objective To investigate the effect of ultrasound-guided microwave ablation(UGMA)combined with absolute ethanol sclerotherapy in the treatment of thyroid cystic-solid nodules.Methods This study was a cohort trail.Fifty-six patients with thyroid cystic-solid nodules treated in Zhengzhou People’s Hospital from August 2021 to August 2023 were selected,and they were divided into the sclerosis group(28 cases)and the UGMA group(28 cases)by random number table method.The UGMA group was treated by UGMA,and the sclerosis group was treated by UGMA combined with absolute ethanol sclerotherapy.The nodule volume reduction rate,stress response indicators,including norepinephrine(NE)and cortisol(COR),thyroid function assessed by thyroid stimulating antibody(TSAb),free thyroxine(FT4)and thyroid stimulating hormone(TSH),and incidence of complications were compared between the two groups.Results Compared with the UGMA group,the nodule volume reduction rate in the sclerosis group was higher 1,3,and 6 months after surgery(P<0.05).Compared with the UGMA group,the levels of NE and COR in the sclerosis group were lower 1 month after surgery(P<0.05).Compared with the UGMA group,the levels of TSAb and FT4 in the sclerosis group were lower,and the level of TSH was higher 1 month after surgery(P<0.05).There was no significant difference in the incidence of complications between the sclerosis group(10.71%,3/28)and the UGMA group(17.86%,5/28),P>0.05.Conclusions UGMA combined with absolute ethanol sclerotherapy is effective in the treatment of thyroid cystic-solid nodules,which can promote the reduction of nodules,and improve the stress response and thyroid function,with high safe.