射频消融治疗甲状腺微小乳头状癌之我见

发布时间：2018-05-01 14:18

本文选题：射频消融 + 甲状腺微小乳头状癌　；参考：《医学与哲学(B)》2017年07期

【摘要】：射频消融(radiofrequency ablation,RFA)是近年发展起来的一种微创治疗技术。在甲状腺外科领域,该技术主要用于治疗甲状腺良性结节和甲状腺癌术后颈部孤立淋巴结转移以及因手术风险过大而无法手术的甲状腺癌患者。然而,国内部分医生盲目扩大了RFA治疗的适应证,甚至将RFA用于可手术的甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)的初始治疗,现有甲状腺结节消融共识和甲状腺癌治疗指南均对此持反对态度。笔者通过总结国内外应用RFA作为PTMC初始治疗的相关文献并结合自己的临床体会,认为目前使用RFA作为PTMC的初始治疗缺乏循证医学证据,不符合肿瘤治疗的"无瘤"原则,明显增加再手术的难度,易损伤甲状腺周围的重要组织器官。在以循证医学为基础的指南出台之前,不推荐使用RFA作为PTMC的初始治疗,临床医生应该严格把握RFA的适应证,引导PTMC患者采取正确的治疗方法。
[Abstract]:Radiofrequency ablation (RFA) is a minimally invasive treatment technique developed in recent years. In the field of thyroid surgery, this technique is mainly used in the treatment of thyroid benign nodules and thyroid cancer patients with cervical solitary lymph node metastasis and the risk of surgery is too high to operate on thyroid cancer patients. However, some doctors in China have blindly expanded the indications for the treatment of RFA, and even used RFA in the initial treatment of papillary thyroid microcarcinoma of the thyroid gland. The current consensus on thyroid nodule ablation and guidelines for the treatment of thyroid cancer are opposed to this. By summarizing the relevant literature on the application of RFA as the initial treatment of PTMC at home and abroad and combining with his own clinical experience, the author considers that the initial treatment of RFA as PTMC lacks evidence-based medical evidence and does not accord with the principle of "tumor free" in tumor treatment. The difficulty of reoperation is obviously increased and the important tissues and organs around the thyroid gland are easily damaged. It is not recommended to use RFA as the initial treatment of PTMC before the guidelines based on evidence-based medicine are issued. Clinicians should strictly grasp the indications of RFA and guide PTMC patients to adopt correct treatment methods.
【作者单位】：中国医科大学附属第一医院甲状腺外科;
【分类号】：R736.1

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