RFA对甲状腺实性结节治疗效果及其优势分析

Effect of RFA on the Treatment of Thyroid Solid Nodules and Its Advantages

目的探讨射频消融术(RFA)在甲状腺实性结节治疗中的应用价值。方法选取2015年1月-2018年1月于我院采用RFA治疗的实性甲状腺结节患者105例(RFA组)、同期采用传统手术治疗的实性甲状腺结节患者104例(对照组),对比两组的手术时间、术后24 h的疼痛程度(VAS评分)、住院时间;观察RFA组的结节缩小率变化,两组患者术前及术后3个月的甲状腺激素(TSH)、血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)水平,术后第1个月及术后3个月的温哥华疤痕量表评分(Vancouver)。结果在RFA手术后,RFA组患者的甲状腺结节直径逐渐减小,在术后12个月时,期结节直径缩小率达到(93.84±7.00)%; RFA组患者的手术时间、术后24 h的VAS评分、住院时间均低于对照组,差异具有统计学意义(P<0.05);术前,RFA组和对照组的血清TSH、FT3、FT4水平差异具有统计学意义(P<0.05);术后3个月,RFA组患者的血清FT3、FT4水平显著高于对照组(P<0.05),血清TSH水平显著低于对照组(P<0.05);术后1个月、术后3个月,RFA组患者的Vancouver评分低于对照组(P<0.05)。结论 RFA在甲状腺实性结节治疗中与传统手术具有相似的临床效果,但是对患者甲状腺功能影响更小、术后疼痛程度更轻且具有较好的美容效果。

Objective To explore the value of radiofrequency ablation(RFA)in the treatment of solid thyroid nodules.Methods From January 2015 to January 2018,105 patients with solid thyroid nodules treated with RFA in our hospital(RFA group)and 104 patients with solid thyroid nodules treated with conventional surgery(control group)were selected.The operation time of the group,the pain level at 24 hours after surgery(VAS score),and the length of hospital stay;the change of nodule reduction rate in the RFA group was observed.The thyroid hormone(TSH)and serum free three in the two groups before and 3 months after operation.Thyroid thyroxine(FT3),serum free thyroxine(FT4)levels,Vancouver scar score scale(Vancouver)at 1 month postoperatively and 3 months postoperatively.Results After RFA surgery,the diameter of thyroid nodules in the RFA group gradually decreased.At 12 months after surgery,the diameter reduction rate of the nodules reached percent 93.84±7.00.The operation time of the RFA group,the VAS score of 24 hours after surgery,The hospital stay was lower than the control group,the difference was statistically significant(P<0.05).Before the operation,the levels of serum TSH,FT3 and FT4 in the RFA group and the control group were statistically significant(P<0.05);The levels of serum FT3 and FT4 in the RFA group were significantly higher than those in the control group(P<0.05),and serum TSH levels were significantly lower than those in the control group(P<0.05).One month after surgery and three months after surgery,the RFA group The patient's Vancouver score was lower than the control group(P<0.05).Conclusion RFA has similar clinical effects to traditional surgery in the treatment of thyroid solid nodules,but it has less effect on thyroid function,less postoperative pain and better cosmetic results.