微波消融技术在甲状腺结节患者治疗中的效果及对甲状腺功能的影响研究

目的 探讨微波消融技术在甲状腺结节患者中的临床效果及对血管内皮生长因子(VEGF),微血管密度(MVD)的影响.方法 2015年6月至2017年6月本院收治的甲状腺结节患者120例,随机数字法分为对照组(n=60)和观察组(n=60).对照组采用常规甲状腺切除术治疗,观察组采用微波消融技术治疗,两组治疗过程中取病灶组织,采用酶联免疫吸附试验检测手术前,后甲状腺激素水平,比较两组临床效果及对血管内皮生长因子,微血管密度的影响.结果 观察组围术期出血量,手术时间,住院时间及手术瘢痕长度,均少(短)于对照组(均P< 0.05);两组术前甲状腺水平比较差异无统计学意义(P>0.05);观察组术后FT3为(9.32:±:1.24)pmol/L,TSH为(2.73±0.51) uIU/L,均低于对照组的(9.31±1.23) pmol/L及(2.64±0.56) uIU/L,均P<0.05,观察组术TT4水平的(2.39±0.63)pmol/L,高于对照组(P<0.05);观察组术后并发症发生率低于对照组(P<0.05).结论 将微波消融技术用于甲状腺结节患者中效果理想,有助于提高结节消退率,改善血管内皮生长因子,微血管密度,值得推广应用.%Objective To investigate the clinical effect of microwave ablation for patients with thyroid nodules and its effects on vascular endothelial growth factor (VEGF) and microvessel density (MVD).Methods 120 patients with thyroid nodules treated at our hospital from June,2015 to June,2017 were retrospectively analyzed.The patients were randomly divided into a control group (n=60) and an observation group (n=60).The control group were treated with conventional thyroidectomy and the observation group with microwave ablation.The pathological tissue of both groups was got during the treatment.The thyroid hormone levels were detected by ELISA before and after operation.The clinical efficacy and the effects on vascular endothelial growth factor and microvessel density were compared between these two groups.Results The bleeding volume,operation time,hospitalization time,and postoperative scar length were shorter in the observation group than in the control group (all P < 0.05).There were no statistical differences in thyroid hormone levels between the 2 groups before operation (P > 0.05).The levels of FT and TSH were lower and the level of TT4 was higher in the observation group than in the control group [(39.32±1.24) pmol/L vs.(9.31±1.23) pmol/L,(2.73±0.51) uIU/L vs.(2.64±0.56) uIU/L,and (2.39±0.63) pmol/Lvs.(1.75±0.43) pmol/L,all P < 0.05].The incidence of complications was lower in the observation group than in the control group (P < 0.05).Conclusion Microwave ablation for patients with thyroid nodules is effective and can improve the nodular regression rate,vascular endothelial growth factor and MVD,so it is worth being generalized.

老年性甲状腺结节的微波消融治疗

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微波消融治疗甲状腺结节的21例临床病例分析

目的 探讨超声引导下经皮穿刺微波消融治疗甲状腺结节的临床疗效及安全性.方法 对21例甲状腺良性结节在局部麻醉下经超声引导行穿刺活检后予微波消融治疗,评价消融区的坏死和萎缩程度、消融后甲状腺及甲状旁腺功能、平均住院日以及消融相关的副作用及并发症.结果 微波消融后超声造影显示消融结节全部丧失血供;21例甲状腺结节微波消融术中无严重并发症发生,术后当天复查患者血清TSH降低,T3、T4、FT3、FT4、TG均轻度升高;术后1月、3月复查:血清TSH、T3、T4、FT3、FT4、TG均恢复正常水平,甲状旁腺功能均未受影响;术后3月消融结节发生萎缩,其中7例结节完全消失,9例结节体积缩小＞50％,3例结节体积缩小25％～50％,2例结节体积缩小＜25％所有病例均未发生颈部皮肤烫伤、感染,无气管、食管、神经、血管及颈部肌肉损伤和运动障碍.结论 超声引导下甲状腺结节微波消融治疗安全性高、创伤小、并发症少、恢复快、疗效确切,是一种值得推广的临床治疗方法.