超声引导下微波消融治疗甲状腺良性结节的预后分析

林少建 张微微 黎洪浩

【摘要】 目的：研究探討超声引导下微波消融治疗甲状腺良性结节的临床效果。方法：选择本院2016年1月-2018年3月收治的83例甲状腺良性结节患者，按照随机数字表法分为对照组40例与观察组43例。对照组实施传统甲状腺切除术，观察组实施超声引导下微波消融介入治疗，比较两组的结节清除率、手术情况、术后切口疼痛评分、术后并发症发生率、术后住院情况、甲状腺功能指标、血清炎症因子指标、术后复发情况。结果：（1）观察组的结节清除率为97.67%，对照组为100%，两组比较差异无统计学意义（P>0.05）。（2）观察组的手术时间短于对照组（P<0.05），其术中出血量少于对照组（P<0.05），其术后各时间点切口疼痛评分、术后并发症总发生率、术后各项血清炎症因子指标均低于对照组（P<0.05），其术后住院天数、住院费用均少于对照组（P<0.05）。（3）两组手术后的各项甲状腺功能指标均较手术前下降（P<0.05），而手术后观察组的各项甲状腺功能指标均高于对照组（P<0.05）。（4）术后随访6个月，对照组、观察组均未出现复发病例。结论：在超声引导下行微波消融介入治疗，可有效清除甲状腺良性结节患者的病灶，还可有效减轻其手术创伤，加快术后恢复，有利于抑制炎症反应，保护其甲状腺功能。

【关键词】 甲状腺良性结节; 微波消融; 介入治疗; 超声引导

【Abstract】 Objective：To investigate the clinical effect of ultrasound-guided microwave ablation for benign thyroid nodules.Method：83 Patients with benign thyroid nodules were selected and collected from January 2016 to March 2018.According to the random digital table method，83 patients with benign thyroid nodules were divided into control group of 40 cases and observation group of 43 cases.The control group received traditional thyroidectomy and the observation group received ultrasound guided microwave ablation interventional therapy.The nodule clearance rate，operation condition，postoperative incision pain score，postoperative complication rate，postoperative hospitalization，thyroid function index，immune function index，serum inflammatory factor index and postoperative recurrence were compared between the two groups.Result：（1）The clearance rate of nodules in the observation group was 97.67%，the control group of that was 100%，there was no significant difference between the two groups（P>0.05）.（2）The operation time in the observation group was shorter than that in the control group，the amount of bleeding during operation was less than that in the control group（P<0.05）.The score of incision pain，the total incidence of postoperative complications and the indexes of serum inflammatory factors after operation in observation group were lower than those in the control group（P<0.05）.The hospitalization days and cost of hospitalization in observation group were lower than that of the control group（P<0.05）.（3）The thyroid function indexes of the two groups after operation were lower than those before operation（P<0.05）.After operation，the thyroid function indexes in the observation group were higher than those in the control group（P<0.05）.（4）There were no recurrence cases in the control group and the observation group after treatment 6 months.Conclusion：The interventional therapy of microwave ablation under the guidance of ultrasound can effectively clear the lesions of patients with benign thyroid nodules，reduce the surgical trauma，accelerate the postoperative recovery，and help to suppress the inflammatory reaction.Protect its thyroid function and immune function.

【Key words】 Benign thyroid nodules; Microwave ablation; Interventional therapy; Ultrasonic guidance

First-authors address：Sun Yat-sen Memorial Hospital，Zhongshan 510120，China

doi：10.3969/j.issn.1674-4985.2019.16.005

甲状腺结节是一种常见的临床疾病，具有较高的发病率，尤其是近年来随着健康体检的普及，甲状腺结节的检出率出现增高，其结节性质以良性为主[1-2]。以往，临床上针对甲状腺良性结节多采取外科手术治疗，但随着医疗理念的转变，甲状腺良性结节治疗时的要求提高，不仅需要清除结节，还需尽可能保留甲状腺功能，在此形势下，微波消融作为介入治疗技术，被逐渐用于甲状腺良性结节治疗中[3-4]。本研究旨在探讨超声引导下微波消融治疗甲状腺良性结节的临床效果，为此，针对83例甲状腺良性结节患者开展研究，现报道如下。

1 资料与方法

1.1 一般资料 选择本院2016年1月-2018年3月收治的83例甲状腺良性结节患者，按照随机数字表法分为对照组40例与观察组43例。本研究经医院伦理学委员会批准，且所选研究对象符合纳入及排除标准。纳入……