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1. 广州中医药大学附属高州中医院外三科
2. 广州中医药大学附属高州中医院超声科
纸质出版日期:2016,
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[1]杨进华,刘海波,伍世绩,汪宇雄,黎杰明,麦永清,熊永辉.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[J].重庆医科大学学报,2016,41(12):1258-1262.
Yang Jinhua, Liu Haibo, Wu Shiji, et al. Research on nodular goiter microwave ablation via percutaneous puncture based on four-dimensional B ultrasound location[J]. Journal of Chongqing Medical University, 2016,41(12):1258-1262.
[1]杨进华,刘海波,伍世绩,汪宇雄,黎杰明,麦永清,熊永辉.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[J].重庆医科大学学报,2016,41(12):1258-1262. DOI: 10.13406/j.cnki.cyxb.001121.
Yang Jinhua, Liu Haibo, Wu Shiji, et al. Research on nodular goiter microwave ablation via percutaneous puncture based on four-dimensional B ultrasound location[J]. Journal of Chongqing Medical University, 2016,41(12):1258-1262. DOI: 10.13406/j.cnki.cyxb.001121.
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(P
<
0.05)
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(P
<
0.005)
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
2
6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。
Objective:To investigate the therapeutic effect
feasibility and safety of nodular goiter microwave ablation via percutaneous puncture based on four-dimensional B ultrasound location. Methods:From January 2014 to August 2015
127 cases of nodular goiter patients were divided into microwave ablation group(64 cases)and open group(63 cases) which underwent subtotal thyroidectomy(including nodules)using the random number distribution. Nodules absorption
the blood loss
operative time
the postoperative complications
postoperative pain degree
hospitalization days
thyroid function of the two patients groups were observed. The long-term following outcomes(≥12 months)in patient adopting microwave ablation were analyzed and summarized. Results:Microwave ablation group was superior to the traditional surgery group in surgical blood loss[(2.13±0.83)vs.(26.30±17.90)
P=0.000)]
operative time[(34.3±10.8)vs.(74.3±26.0)
P=0.000]
postoperative hospitalization days[(3.64±1.23)vs.(10.50±3.15)
P=0.000]. In addition
microwave ablation group was inferior to the open group in the aspect of degree of pain(u=270.000
P=0.000)and complications(P=0.010). Analysis of the thyroid function of two groups showed that there was interaction between the ablation group and open group in thyroid function
with significant difference at each time point(P<0.05). In addition to T4
there were differences in the other thyroid function in the main effect factors(P<0.005)and the level fluctuation is low in the ablation group. Twenty-seven patients in ablation group underwent follow-up observation for more than 12 months. After 12 to 26 months follow-up post-ablation
the total absorption rate in patients with 18 to 21 months after ablation was 66.67%(n=6)and in patients with 21 to 26 months of follow-up was 100%(n=10). One patient with recurrence was found. One patient with new small nodule was observed. No patient with hypothyroidism was found. Conclusion:With the advantages of few postoperative complications
surgical blood loss
operative time
postoperative hospitalization time and postoperation pain
microwave ablation is a kind of minimally invasive
safe and feasible technique in the treatment of nodular goiter.
微波消融结节性甲状腺肿微创安全美容
microwave ablationnodular goiterminimally invasive surgerysafetycosmetology
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