微波消融与射频消融治疗实性为主的甲状腺良性结节的近期疗效比较

Comparison of short-term efficacy between microwave ablation and radiofrequency ablation in treatment of solid dominant benign thyroid nodules

目的比较超声引导下微波消融(MWA)与射频消融(RFA)治疗实性为主的甲状腺良性结节的近期疗效。方法回顾性选取2018年1月至2023年12月在浙江省医疗健康集团杭州医院接受超声引导下热消融治疗的甲状腺结节患者72例(75个结节),其中采取MWA 38例(41个结节),采取RFA 34例(34个结节);比较MWA组与RFA组患者结节消融时间、并发症发生率以及手术前后甲状腺体积和体积缩小率(VRR)、甲状腺功能。结果MWA组结节消融时间长于RFA组,单位体积消融时间短于RFA组,差异均有统计学意义(均P<0.01)。两组患者术后6个月甲状腺结节体积均较术前明显缩小(均P<0.05),组间VRR比较差异无统计学意义(P=0.920)。两组患者术前及术后1个月促甲状腺激素、FT_(3)、FT_(4)、T_(4)水平均在正常范围内,组间比较差异均无统计学意义(均P>0.05)。RFA组并发症合计发生率明显低于MWA组(P=0.037)。结论MWA与RFA治疗实性为主的甲状腺良性结节各有优缺点,疗效相似。

Objective To compare the short-term efficacy of ultrasound-guided microwave ablation(MWA)and radio frequency ablation(RFA)in the treatment of solid dominant benign solid thyroid nodules.Methods A retrospective analysis was conducted on the clinical data of 72 patients with solid dominant benign thyroid nodules(75 nodules).They were treated with ultrasound-guided thermal ablation in Zhejiang Medical&Health Group Hangzhou Hospital and were selected from January 2018 to December 2023.According to the ablation method,the patients were divided into MWA group(38 patients,41 nodules)and RFA group(34 patients,34 nodules).The two groups were compared in the ablation time,incidence of complications,and the size of nodules,and the nodule volume reduction rate(VRR)before and six months after surgery,as well as thyroid function indicators before and one month after surgery.Results The thyroid nodule ablation time in MWA group was significantly longer than that of RFA group,while the unit volume ablation time was significantly shorter than that of RFA group(both P<0.01).Compared with that before surgery,the thyroid nodule volume in both groups was significantly decreased at 6 months after surgery(both P<0.05).There was no significant difference in VRR of thyroid nodules between two groups at 6 months after surgery(P=0.920).In both groups,the levels of thyrotropin,FT_(3),FT_(4)and T_(4)before and one month after surgery were all within the normal range,and there was no statistical significance between the two groups(all P>0.05).The incidence of complications during and after ablation in RFA group was significantly lower than that of MWA group(P=0.037).Conclusion MWA and RFA have their own advantages and disadvantages in the treatment of solid dominant benign thyroid nodules with similar efficacy.