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经皮激光消融治疗无功能性良性甲状腺结节患者的生活质量:一项前瞻性单中心研究。

Quality of Life in Patients Treated with Percutaneous Laser Ablation for Non-Functioning Benign Thyroid Nodules: A Prospective Single-Center Study.

机构信息

Endocrinology Unit, IRCSS San Martino University Hospital-IST, Largo Rosanna Benzi, n°10, I-16132 Genoa, Italy.

Laboratory Medicine Service Unit, IRCSS San Martino University Hospital-IST, Largo Rosanna Benzi, n°10, I-16132 Genoa, Italy.

出版信息

Korean J Radiol. 2018 Jan-Feb;19(1):175-184. doi: 10.3348/kjr.2018.19.1.175. Epub 2018 Jan 2.

Abstract

OBJECTIVE

While many studies have reported that laser ablation (LA) for benign non-fuctioning thyroid nodules is efficacious in reducing nodular volume and neck symptoms, none have described changes in quality of life (QoL). The purpose of this study was to report post-LA changes in QoL in our cohort of patients.

MATERIALS AND METHODS

Fourteen patients with benign thyroid nodules were involved in a prospective, single-center study and underwent a single session of LA. We evaluated the following: changes in nodule volume, thyroid function, and autoimmunity; adverse events during and after LA; changes in neck discomfort by means of a visual analogic scale (VAS) at one week and 1, 3, 6, and 12 months; and changes in QoL through the 13-scale Thyroid-specific Patient Reported Outcome (ThyPRO) questionnaire at 1, 3, 6, and 12 months. ThyPRO is a validated questionnaire for thyroid diseases, which consists of 13 scales with multiple-choice answers. They investigate several aspects of life that may be impaired by goiter-related compression symptoms, by esthetic alterations and by hypo- or hyperthyroidism.

RESULTS

Nodule volume decrease was -37 ± 23%, -55 ± 22%, -53 ± 25%, -58 ± 25% ( < 0.01 vs. baseline) at the first, third, sixth, and twelfth month, respectively. No hypothyroidism or positivization of autoimmunity was observed. There were no major complications during or after LA. After LA, VAS scores improved significantly from 1 week onwards in 100% of patients, while a significant improvement was seen in the goiter symptoms score after one month, and in the general score and mean values of ThyPRO after six months. Scores on the other ThyPRO scales did not change significantly.

CONCLUSION

Laser ablation is safe and effective in reducing nodule volume and neck symptoms; this is confirmed by improvements in the goiter scale, general score, and mean values of ThyPRO and in the VAS score.

摘要

目的

虽然许多研究报告称,激光消融(LA)治疗良性非功能性甲状腺结节可有效减少结节体积和颈部症状,但尚无研究描述生活质量(QoL)的变化。本研究旨在报告我们的患者队列在 LA 后的 QoL 变化。

材料与方法

14 例良性甲状腺结节患者参与了一项前瞻性、单中心研究,并接受了单次 LA 治疗。我们评估了以下内容:结节体积、甲状腺功能和自身免疫的变化;LA 期间和之后的不良事件;通过视觉模拟量表(VAS)在 1 周、1、3、6 和 12 个月评估颈部不适的变化;通过 13 项甲状腺特异性患者报告结局(ThyPRO)问卷在 1、3、6 和 12 个月评估 QoL 的变化。ThyPRO 是一种经过验证的甲状腺疾病问卷,由 13 个具有多项选择答案的量表组成。它们调查了可能因甲状腺肿相关压迫症状、美容改变和甲状腺功能减退或甲状腺功能亢进而受损的生活的几个方面。

结果

结节体积在第 1、3、6 和 12 个月时分别减少了 -37 ± 23%、-55 ± 22%、-53 ± 25%、-58 ± 25%(<0.01 与基线相比)。未观察到甲状腺功能减退或自身免疫阳性。LA 期间或之后无重大并发症。LA 后,100%的患者在 1 周后 VAS 评分显著改善,1 个月后甲状腺肿症状评分显著改善,6 个月后总体评分和 ThyPRO 的平均值显著改善。其他 ThyPRO 量表的评分没有显著变化。

结论

激光消融可安全有效地减少结节体积和颈部症状;这得到了甲状腺肿量表、总体评分和 ThyPRO 的平均值以及 VAS 评分的改善的证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7555/5768500/1bebc20c6705/kjr-19-175-g001.jpg

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