微波消融治疗结节性甲状腺肿对甲状腺功能影响的临床观察

发布时间：2018-06-29 19:18

本文选题：结节性甲状腺肿 + 微波消融术　；参考：《介入放射学杂志》2017年06期

【摘要】：目的通过超声引导下微波消融(MWA)治疗与手术治疗结节性甲状腺肿的对比研究,探讨MWA治疗结节性甲状腺肿对甲状腺功能的影响。方法选择2010年1月至2013年1月行超声引导下MWA治疗结节性甲状腺肿患者50例为观察组,其中8例行单侧叶结节消融,42例行双侧叶结节消融;另选同期因结节性甲状腺肿行甲状腺部分切除术的患者96例为对照组,其中52例因单侧叶结节甲状腺部分切除,44例因双侧叶结节甲状腺部分切除。分析观察组与对照组术后并发症及术后1周,1、3、6和12个月血清FT3、FT4、TSH指标的变化。结果 MWA术后随访12个月,观察组所有病例无并发症发生,术后1周血清FT3、FT4水平较术前升高,TSH下降,差异有统计学意义(P0.05),术后1、3、6和12个月FT3、FT4、TSH均在正常范围,差异无统计学意义(P0.05)。对照组术后出血窒息1例,声音嘶哑5例,低钙抽搐3例。甲状腺部分切除后1周血清FT3、FT4水平较术前升高,TSH下降,差异有统计学意义(P0.05),其中甲状腺双侧叶部分切除的44例患者临床常规于手术后1周给予甲状腺素替代治疗,3例单侧叶部分切除的患者分别于术后3、6和8个月时出现甲状腺功能低下,其余49例单侧叶部分切除的患者术后1、3、6和12个月血清FT3、FT4、TSH与观察组同期比较,差异有统计学意义(P0.05)。结论超声引导下MWA治疗结节性甲状腺肿方法安全,对甲状腺功能影响轻微,显著优于结节性甲状腺肿甲状腺部分切除治疗术,值得临床推广。
[Abstract]:Objective to investigate the effect of ultrasound guided microwave ablation (MWA) on thyroid function in the treatment of nodular goiter. Methods from January 2010 to January 2013, 50 patients with nodular goiter were treated with MWA under the guidance of ultrasound. Among them, 8 cases were treated with unilateral lobar nodule ablation and 42 cases with bilateral lobar nodular ablation. In addition, 96 patients with nodular goiter underwent partial thyroidectomy at the same time as control group, of which 52 were treated with partial thyroidectomy of unilateral lobar nodule and 44 with partial thyroidectomy of bilateral lobar nodule. The postoperative complications in the observation group and the control group were analyzed, and the changes of TSH in serum FT3 / FT4 / TSH at 1 week and 12 months after operation were also analyzed in the observation group and the control group. Results there were no complications in all patients in the observation group after 12 months follow-up, and the level of serum FT3 FT 4 decreased significantly 1 week after MWA compared with the preoperative level (P0.05). The levels of TSH in all cases were in the normal range (P 0.05), and there was no significant difference between the two groups in 1 month and 12 months after the operation (P0.05). In the control group, hemorrhage asphyxia was found in 1 case, hoarseness in 5 cases and hypocalcemia in 3 cases. 1 week after partial thyroidectomy, the serum FT3 FT 4 level increased and TSH decreased. The difference was statistically significant (P0.05), in which 44 patients with bilateral partial thyroidectomy received thyroxine replacement therapy 1 week after operation and 3 patients with unilateral partial lobectomy were treated with thyroxine replacement therapy at 3 and 8 months after operation, respectively. At present, the thyroid function is low, The other 49 patients with unilateral partial lobectomy had significant difference in serum FT3 / FT4 TSH (P0.05) compared with the control group (P 0.05). Conclusion Ultrasound-guided treatment of nodular goiter with MWA is safe and has a slight effect on thyroid function, which is significantly better than partial thyroidectomy for nodular goiter. It is worth popularizing in clinic.
【作者单位】：滨州医学院烟台附属医院超声科;
【基金】：山东省科技发展计划(2011YD18028) 烟台市科技攻关计划(2010156)
【分类号】：R581.3

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