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超声引导下微波消融治疗435例良性甲状腺结节

Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients.

作者信息

Liu Yu-Jiang, Qian Lin-Xue, Liu Dong, Zhao Jun-Feng

机构信息

Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

出版信息

Exp Biol Med (Maywood). 2017 Sep;242(15):1515-1523. doi: 10.1177/1535370217727477. Epub 2017 Aug 28.

Abstract

The objective of the present study was to investigate the effectiveness and safety of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. A total of 474 benign thyroid nodules in 435 patients who underwent ultrasound-guided microwave ablation from September 2012 to August 2015 were included. Nodule volume and thyroid function were measured before treatment and at 1, 3, 6, and 12 months and subsequently after every 6 months. The nodule volume reduction rate and changes of thyroid function were evaluated. The volume of all thyroid nodules significantly decreased after ultrasound-guided microwave ablation. The average volume was 13.07 ± 0.95 ml before treatment, and 1.14 ± 0.26 ml at 12-months follow-up. The mean volume reduction rate was 90% and the final volume reduction rate was 94%. The volume reduction rate of mainly cystic nodules was significantly higher than that of simple solid and mainly solid nodules (all P < 0.05). The pretreatment volume of nodules was positively correlated with the final volume reduction rate at final follow-up ( P = 0.004). No serious complications were observed after treatment. In conclusion, ultrasound-guided microwave ablation is an effective and safe technique for treatment of benign thyroid nodules, and has the potential for clinical applications. Impact statement Ultrasound-guided MWA is an effective and safe technique for the treatment of benign thyroid nodules. It can significantly reduce the nodule volume, improve the patients' clinical symptoms, has less complication, guarantees quick recovery, meets patients' aesthetic needs, and shows less interference on the physiological and psychological aspects of the body. MWA should be a good complement to traditional open surgery and has potentials in clinical applications.

摘要

本研究的目的是探讨超声引导下微波消融治疗良性甲状腺结节的有效性和安全性。纳入了2012年9月至2015年8月期间接受超声引导下微波消融治疗的435例患者的474个良性甲状腺结节。在治疗前、治疗后1、3、6和12个月以及随后每6个月测量结节体积和甲状腺功能。评估结节体积缩小率和甲状腺功能变化。超声引导下微波消融后所有甲状腺结节的体积均显著减小。治疗前平均体积为13.07±0.95ml,随访12个月时为1.14±0.26ml。平均体积缩小率为90%,最终体积缩小率为94%。主要为囊性结节的体积缩小率显著高于单纯实性和主要为实性的结节(所有P<0.05)。结节的治疗前体积与最终随访时的最终体积缩小率呈正相关(P=0.004)。治疗后未观察到严重并发症。总之,超声引导下微波消融是治疗良性甲状腺结节的一种有效且安全的技术,具有临床应用潜力。影响声明:超声引导下微波消融是治疗良性甲状腺结节的一种有效且安全的技术。它可显著缩小结节体积,改善患者临床症状,并发症少,保证恢复快,满足患者美观需求,对身体的生理和心理方面干扰小。微波消融应是传统开放手术的良好补充,具有临床应用潜力。

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