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中南大学湘雅三医院超声科
纸质出版日期:2022,
网络出版日期:2022-11-25,
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戴婷, 周平, 李稳刚. 超声引导下经皮激光消融治疗甲状腺良性结节的疗效及影响因素[J]. 临床超声医学杂志, 2022,24(11).
The effect and influencing factors of ultrasound-guided percutaneous laser ablation for the treatment of benign thyroid nodules[J]. Journal of Clinical Ultrasound in Medicine, 2022,24(11).
目的:探讨对甲状腺良性结节超声引导下经皮激光消融(percutaneous laser ablation,PLA)的疗效及影响因素。方法:对164例接受PLA治疗的甲状腺良性结节的临床资料进行回顾性分析,对其术后2年的随访资料进行评估,包括结节的体积及体积缩小率(volume reduction ratio,VRR),并评价影响PLA疗效的相关因素。结果:甲状腺良性结节PLA术后2年内体积明显缩小,对比术前差异有统计学意义(P均<0.05),术后1、3、6、12、18及24个月VRR分别为:(5.2±71.1)%,(45.5±41.7)%,(70.4±26.3)%,(86.3±16.3)%,(87.8±15.6)%,(89.2±15.1)%;甲状腺结节按内部成分不同分组,术后1、3个月组间VRR差异具有统计学意义(P<0.05),以囊性为主的结节VRR更大;将实性结节按照体积分组,术后6个月至24个月组间VRR差异有统计学意义(P均<0.001), 5ml以下的实性结节消融后VRR更大。多元线性回归分析显示,结节初始体积是影响随访终点VRR唯一影响因素。结论:PLA治疗甲状腺良性结节是一种安全、有效的微创治疗方法,结节初始体积是对术后VRR唯一影响因素。
Objective: To explore the curative effect and influencing factors of ultrasound (US)-guided percutaneous laser ablation (PLA) for benign thyroid nodules. Methods: The study included 164 benign thyroid nodules and followed up 2 years after the PLA treatment. Nodule volume and VRR were evaluated before PLA treatment and during follow-up. The factors related to efficacy were evaluated. Results :The volume of benign thyroid nodules after the PLA treatment was significantly reduced after 1
3
6
12,18,24 months
and their nodule VRR was(5.2±71.1)%,(45.5±41.7)%,(70.4±26.3)%,(86.3±16.3)%,(87.8±15.6)%,(89.2±15.1)% respectively. The thyroid nodules were divided into 3 groups according to the cystic portion
significant differences were found in the VRR at 1 and 3 months after PLA ( P<0.05)
the cystic nodule were the fastest one the lesion shrunk. The nodules with the solid portion were grouped according to the volume of the nodules ( ≤ 5 ml /5~10ml/>10ml); and significant differences were found in the VRR at 6~24 months after PLA (The VRR of nodules of which the volume ≤ 5 ml was larger). Multiple linear regression analysis showed that initial nodule volume (P<0.001) was the only independent factors predicting final VRR. Conclusions: US-guided PLA is a safe and effective minimally invasive therapy for benign thyroid nodules. The initial volume of the nodules will affect the postoperative VRR.
超声引导经皮激光消融疗效甲状腺良性结节
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