Xu Bin, Zhou Ning-Ming, Cao Wei-Tian, Gu Shu-Yan
Department of Ultrasound, Fudan University Affiliated Shanghai Fifth People's Hospital, Shanghai 200240, China.
World J Clin Cases. 2018 Dec 6;6(15):936-943. doi: 10.12998/wjcc.v6.i15.936.
To compare the effect and postoperative trauma of ultrasound-guided percutaneous microwave ablation and surgical resection in the treatment of papillary thyroid microcarcinoma (PTMC).
Eighty-seven patients with PTMC treated at Fudan University affiliated Shanghai Fifth People's Hospital were enrolled as subjects. The patients were divided into a microwave ablation group (41 cases) and a surgical group (46 cases). The operative time, intraoperative blood loss, length of hospital stay, serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), thyroid-related hormonal changes, and complications 7 d and 30 d after surgery were observed.
The operative time, intraoperative blood loss, and length of hospital stay in the surgical group were significantly higher than those in the microwave ablation group ( < 0.05). The levels of CRP, IL-6, and TNF-α in the surgical group were significantly higher than those in the microwave ablation group ( < 0.05). The free triiodothyronine (FT3) and free thyroxin (FT4) levels in the surgical group were significantly lower than those in the microwave ablation group ( < 0.05). However, the postoperative thyroid stimulating hormone (TSH) level was significantly higher than that in the microwave ablation group ( < 0.05). There were significant interactions between the FT3, FT4, and TSH 7 d and 30 d after operation and the treatment methods ( < 0.05). There was no significant difference in the complications between the two groups ( > 0.05).
Microwave ablation for papillary microcarcinoma of the thyroid gland has less trauma to the body, quicker recovery, and no scars. It can effectively shorten the length of hospital stay and improve the quality of life of patients.
比较超声引导下经皮微波消融术与手术切除治疗甲状腺微小乳头状癌(PTMC)的疗效及术后创伤。
选取复旦大学附属上海第五人民医院收治的87例PTMC患者作为研究对象。将患者分为微波消融组(41例)和手术组(46例)。观察手术时间、术中出血量、住院时间、血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、甲状腺相关激素变化以及术后7天和30天的并发症情况。
手术组的手术时间、术中出血量和住院时间均显著高于微波消融组(P<0.05)。手术组的CRP、IL-6和TNF-α水平显著高于微波消融组(P<0.05)。手术组的游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平显著低于微波消融组(P<0.05)。然而,术后促甲状腺激素(TSH)水平显著高于微波消融组(P<0.05)。术后7天和30天的FT3、FT4和TSH与治疗方法之间存在显著交互作用(P<0.05)。两组并发症差异无统计学意义(P>0.05)。
甲状腺微小乳头状癌微波消融术对机体创伤小,恢复快,无瘢痕,能有效缩短住院时间,提高患者生活质量。