摘要
目的 探讨超声引导下聚桂醇注射液硬化治疗不同类别良性甲状腺囊性结节(囊性成分占比≥50%)的疗效及安全性。方法 选取我院经病理确诊的良性甲状腺囊性结节患者68例,共69个结节,所有结节均经超声引导下聚桂醇注射液硬化治疗,应用超声测量治疗前及治疗后3、12个月结节体积,并计算治疗后12个月结节体积缩小率(VRR)评估其疗效,比较不同体积、囊液颜色、囊液性状、囊性成分占比结节的总有效率;记录治疗及随访期间患者不良反应发生情况。结果 69个结节中63个治疗有效,总有效率为91.3%,其中5个结节进行了二次硬化治疗且VRR≥50%。不同囊性成分占比结节的总有效率比较差异有统计学意义(P<0.001),其中囊性成分占比≥70%~90%结节和囊性成分占比≥90%结节的总有效率均为100%,与囊性成分占比≥50%~70%结节的总有效率(45.45%)比较差异均有统计学意义(均P<0.001)。非胶质结节的总有效率(94.23%)高于胶质结节的总有效率(82.35%),差异有统计学意义(P=0.011)。不同囊液颜色、不同体积结节的总有效率比较差异均无统计学意义。治疗后所有患者均无严重并发症发生,其中6例(8.8%)患者出现短暂且轻微的不良反应(轻微疼痛、发热、面部潮红、恶心、头晕等)。结论 超声引导下聚桂醇注射液硬化治疗良性甲状腺囊性结节不良反应少,临床疗效佳,尤其对囊性成分占比≥70%、非胶质甲状腺结节的疗效更佳。
Objective To explore the efficacy and safety of ultrasound-guided lauromacrogol sclerotherapy in the treatment of different type of benign cystic thyroid nodules with cystic components proportion≥50%.Methods A total of 68 patients with benign thyroid cystic nodules confirmed by pathological examination in our hospital were selected,with a total of 69 nodules.All nodules were treated with ultrasound-guided lauromacrogol sclerotherapy,and the nodule volumes were measured at pre-treatment and 3,12 months post-treatment.The volume reduction rate(VRR)was calculated at 12 months post-treatment,and the efficacy was evaluated.The total effective rate of different volume,cyst fluid color,fluid characteristics,and the proportion of cystic versus solid components were compared.Adverse reactions during treatment and follow-up were also recorded.Results Among 69 nodules,63 were effectively treated,with the total effective rate of 91.3%.5 nodules underwent a second sclerotherapy,achieving a VRR≥50%.There was a statistically significant difference in total effective rate among nodules with different cystic components proportions(P<0.001).The total effective rate of nodules with cystic components proportion≥70%~90%and cystic components proportion≥90%were both 100%,which were significantly higher than that of the nodules with cystic components proportion≥50%~70%(45.45%),the differences were statistically significant(both P<0.001).Non-gelatinous nodules had a significantly higher total effective rate(94.23%)compared with gelatinous nodules(82.35%),the difference was statistically significant(P=0.011).There were no significant differences in total effective rate among different cyst fluid color or nodule volume.6 patients(8.7%)experienced mild,transient adverse reactions(such as mild pain,fever,facial flushing,nausea,and dizziness).Conclusion Ultrasound-guided lauromacrogol sclerotherapy is a safe and effective alternative to treat benign cystic thyroid nodules,particularly effective in cyst-dominant nodules(cystic components proportion≥70%)and non-gelatinous nodules.
作者
梁晓秋
曹凌玲
陈溢旭
石磊
邱逦
LIANG Xiaoqiu;CAO Lingling;CHEN Yixu;SHI Lei;QIU Li(Department of Ultrasound Medicine,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《临床超声医学杂志》
CSCD
2024年第11期891-895,共5页
Journal of Clinical Ultrasound in Medicine
基金
成都市卫生和计划生育委员会课题(2021205)。
关键词
超声引导
聚桂醇
硬化疗法
甲状腺结节
囊性
Ultrasound-guided
Lauromacrogol
Sclerotherapy
Thyroid nodules
Cystic