四维B超引导定位穿刺结节性甲状腺肿微波消融术应用研究

发布时间：2018-03-29 10:54

  本文选题：微波消融　切入点：结节性甲状腺肿　出处：《重庆医科大学学报》2016年12期

【摘要】：目的:探讨四维B超引导定位下穿刺微波消融治疗结节性甲状腺肿(简称"结甲肿")的临床效果和可行性、安全性。方法:将2014年1月至2015年8月收治的127例结甲肿患者,采用随机数字分配原则,分为结甲肿微波消融(消融组)64例,开放术式甲状腺大部分切除含结节(开放组)63例。对2组患者术后结节吸收情况、术中出血量、手术时间、术后并发症和术后疼痛、住院天数、甲状腺功能等进行比较。并总结结节消融后≥12个月的中远期随访结果。结果:消融组术中出血量[(2.13±0.83)vs.(26.30±17.90),P=0.000]、手术时间[(34.3±10.8)vs.(74.3±26.0),P=0.000]和住院天数[(3.64±1.23)vs.(10.50±3.15),P=0.000]方面明显优于开放组。此外,消融组术后疼痛的程度较开放组小(u=270.000,P=0.000),并发症的发生也低于开放组(P=0.010)。通过对2组甲状腺功能的分析,消融组与开放组的甲状腺功能各项存在交互作用,各个时间点的差异均有统计学意义(P0.05),除T4外,其他甲状腺功能各项在处理因素的主效应均存在差异性(P0.005),而且消融组的均数水平波动较小。消融组术后≥12个月的中远期随访患者27例,经12~26个月的随访检查,消融后≥18个月且21个月的6例患者,结节完全吸收率占66.67%;消融后≥21个月且26个月的10例患者,结节完全吸收率达100%。消融后结节复发1例,发现新生小结节1例,未发现甲状腺功能减退症病例。结论:微波消融比开放术式治疗结甲肿的并发症和出血量少、手术时间和住院天数短、术后疼痛轻,对甲状腺功能影响小,是一种微创、美容、安全可行、效果确切的新技术。
[Abstract]:Objective: to investigate the clinical effect, safety and safety of microwave ablation for nodular goiter guided by four-dimensional B-ultrasound. Methods: 127 patients with nodular goiter were treated from January 2014 to August 2015. According to the principle of random digital distribution, the patients were divided into two groups: the ablation group (n = 64) and the open operation group (n = 63). Postoperative complications and postoperative pain, hospital stay, Results: the intraoperative bleeding volume [2.13 卤0.83)vs.(26.30 卤17.90], the operative time [34.3 卤10.8)vs.(74.3 卤26.0P0.000] and the length of hospitalization [3.64 卤1.23)vs.(10.50 卤3.15P0.000] in the ablation group were significantly better than those in the open group. The degree of postoperative pain in the ablation group was lower than that in the open group, and the incidence of complications was lower than that in the open group. Through the analysis of thyroid function in the two groups, there was interaction between the ablation group and the open group. The differences at all time points were statistically significant (P 0.05), except for T4, There were significant differences in the main effects of other thyroid function factors (P 0.005), and the mean level of the ablation group fluctuated little. 27 patients with 鈮，

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