Department of Endocrinology, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China.
Department of Ultrasound Medicine, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), 454000, Jiaozuo, China.
Endocrine. 2019 Jul;65(1):138-143. doi: 10.1007/s12020-019-01900-5. Epub 2019 Mar 23.
To compare the effects and safety of using microwave ablation (MWA) and surgical resection for the treatment of benign thyroid nodules (BTNs) under ultrasonic guidance and investigate the effects of this treatment on stress response.
Patients with BTNs were divided into the MWA and operation groups (72 cases each). Interleukin (IL)-6, IL-8, serum tumor necrosis factor (TNF-α), and hydrostatic visual analog scale (VAS) prior to the operation, at 6 h, 24 h, and 72 h post-operation were compared between the two groups. Operation times, hospitalization times, hospitalization expenses, and postoperative complications in the two groups were also compared. All patients underwent routine ultrasound and thyroid function testing at 3 and 6 months post-operation for assessment of nodule changes and thyroid hormone levels.
Compared to the MWA group, the operation group had longer average operation times, longer hospital stays, a higher rate of neck pain after surgery, and a higher rate of fever (P < 0.05). Body temperature, as well as VAS, IL-6, IL-8, and TNF-α levels in the operation group were higher than those in the MWA group at 6 h, 24 h, and 72 h post-operation (P < 0.05). The levels of free thyroxine and free triiodothyronine in the operation group were lower than those in the MWA group (P < 0.05).
MWA is a safe and effective treatment for patients with BTNs. The effects of MWA are more tolerable than those of surgical resection and the physiological function of the thyroid is preserved, which has high clinical value.
比较超声引导下微波消融（MWA）与手术切除治疗良性甲状腺结节（BTN）的疗效和安全性，并探讨该治疗方法对机体应激反应的影响。
将 BTN 患者分为 MWA 组和手术组（各 72 例）。比较两组患者术前、术后 6 h、24 h、72 h 白细胞介素（IL）-6、IL-8、血清肿瘤坏死因子（TNF）-α和静水视觉模拟评分（VAS）；比较两组患者的手术时间、住院时间、住院费用及术后并发症。所有患者术后 3、6 个月常规行超声及甲状腺功能检查，评估结节变化及甲状腺激素水平。
与 MWA 组相比，手术组的平均手术时间更长，住院时间更长，术后颈部疼痛发生率更高，发热发生率更高（P<0.05）。术后 6 h、24 h、72 h，手术组的体温、VAS、IL-6、IL-8、TNF-α水平均高于 MWA 组（P<0.05）。手术组游离甲状腺素和游离三碘甲状腺原氨酸水平低于 MWA 组（P<0.05）。
MWA 治疗 BTN 安全有效，疗效优于手术切除，且保留了甲状腺的生理功能，具有较高的临床应用价值。
