a Department of General Surgery , Panzhihua Central Hospital , Panzhihua , China.
Int J Hyperthermia. 2018 Aug;34(5):606-610. doi: 10.1080/02656736.2018.1427286. Epub 2018 Jan 24.
In this study, we compared the systemic stress response induced by microwave ablation with that induced by conventional open surgery for treatment of benign thyroid nodules.
A total of 108 patients with benign thyroid nodules were randomly assigned to receive ultrasound-guided thyroid microwave ablation (microwave group, n = 57) and conventional open thyroid surgery (open group, n = 51). Body temperature, white blood cell (WBC) counts, visual analogue scale (VAS) scores for pain, and serum levels of high sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6) and cortisol were measured at 24 h before operation and at 8 h, 24 h and 48 h after operation.
No significant between-group differences were observed with respect to preoperative body temperature, VAS scores, WBC counts, serum hs-CRP, IL-6 and cortisol levels. Patients in the open group exhibited higher body temperature at 24 h after operation and higher WBC counts at both 24 h and 48 h after operation, as compared to those in the microwave group. As compared with microwave ablation, open surgery was associated with significantly higher VAS scores, and significantly higher serum levels of hs-CRP, IL-6 and cortisol at all postoperative time-points (8 h, 24 h and 48 h).
Microwave ablation induces a lower systemic stress response than open surgery for treatment of benign thyroid nodules.
本研究比较了微波消融与传统开放手术治疗良性甲状腺结节引起的全身应激反应。
将 108 例良性甲状腺结节患者随机分为超声引导下甲状腺微波消融组（微波组，n=57）和传统开放甲状腺手术组（开放组，n=51）。分别于术前 24 h 和术后 8 h、24 h、48 h 测量体温、白细胞计数（WBC）、疼痛视觉模拟评分（VAS）和血清高敏 C 反应蛋白（hs-CRP）、白细胞介素 6（IL-6）和皮质醇水平。
两组患者术前体温、VAS 评分、WBC 计数、血清 hs-CRP、IL-6 和皮质醇水平无显著差异。与微波组相比，开放组术后 24 h 体温较高，术后 24 h 和 48 h WBC 计数较高。与微波消融相比，开放手术在所有术后时间点（8 h、24 h 和 48 h）的 VAS 评分以及血清 hs-CRP、IL-6 和皮质醇水平均显著升高。
微波消融治疗良性甲状腺结节引起的全身应激反应低于开放手术。
