目的：观察超声引导下微波消融（MWA）治疗甲状腺良性结节（BTN）的近远期疗效及对促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）水平的影响。方法：选取95例BTN患者，根据治疗方式的不同将其分为常规组（46例，常规甲状腺切除术治疗）和观察组（49例，超声引导下MWA治疗）。比较2组围术期相关指标；观察观察组术后1、3、6、12、18月疗效；比较2组术前，术后6月TSH、FT3、FT4水平；统计并比较2组并发症发生情况。结果：观察组手术时间、住院时间均短于常规组（P＜0.05），术中出血量少于常规组（P＜0.05），术后疤痕长度短于常规组（P＜0.05）；随着术后时间的延长，观察组结节体积呈显著缩小趋势（P＜0.05），结节缩小率呈显著上升趋势（P＜0.05）；术后6月常规组TSH水平升高（P＜0.05），FT3、FT4水平均降低（P＜0.05），且观察组TSH水平低于常规组（P＜0.05），FT3、FT4水平均高于常规组（P＜0.05）；观察组总并发症发生率低于常规组（P＜0.05）。结论：超声引导下MWA治疗BTN近远期疗效确切，相较于常规甲状腺切除术手术时间更短、术中出血量更少、疤痕更短、恢复速度更快、对甲状腺功能影响更小，且在减少并发症上具有优势。
Abstract
Objective: To observe the short-term and long-term effects of ultrasound-guided microwave ablation(MWA) in the treatment of benign thyroid nodules(BTN) and its effects on thyroid stimulating hormone(TSH), free triiodothyronine(FT3) and free thyroxine(FT4) level of influence. Methods: Ninety-five patients with BTN were divided into the conventional group(46 cases, conventional thyroidectomy) and the observation group(49 cases, ultrasound-guided MWA treatment) depending on the treatment. The perioperative parameters of the two groups were compared. The curative effect at 1, 3, 6, 12, 18 months postoperatively of observation group was observed. The levels of TSH, FT3, and FT4 before operation and 6 months after operation were compared of the two groups. The complications were statisticed and compared between the two groups. Results: The operation time and hospitalization time of the observation group were shorter than those of the conventional group(P<0.05), which of the intraoperative blood loss was less than that of the conventional group(P<0.05), which of the postoperative scar length was shorter than the conventional group(P<0.05). After the prolongation of time, the volume of nodules in the observation group showed a significant decrease(P<0.05), and the rate of nodule reduction showed a significant increase(P<0.05). The level of TSH in the conventional group increased 6 months after operation(P<0.05), which of the levels of FT3 and FT4 were reduced(P<0.05). The TSH level of the observation group was lower than that of the conventional group(P<0.05), which of the FT3 and FT4 levels were higher than those of the conventional group(P<0.05). The total complication rate of the observation group was lower than that of the conventional group(P<0.05). Conclusion: Ultrasound-guided MWA is effective in the treatment of BTN in short-term and long-term. Compared with conventional thyroidectomy, its operation time is shorter, intraoperative blood loss is less, scar is shorter, the recovery speed is faster, the thyroid function is less affected, and the complications are less.
关键词
甲状腺结节 /
微波 /
超声检查 /
多普勒 /
彩色
Key words
Thyroid nodule /
Microwaves /
Ultrasonography, Doppler, color
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基金
河南省2018年科技发展计划（182102310233）。
