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超声引导下经皮微波消融与甲状旁腺切除术治疗原发性甲状旁腺功能亢进症的比较。

Comparison of ultrasound-guided percutaneous microwave ablation and parathyroidectomy for primary hyperparathyroidism.

机构信息

Department of Interventional Ultrasound, Chinese PLA General Hospital , Beijing , China.

Department of General Surgery, Chinese PLA General Hospital , Beijing , China.

出版信息

Int J Hyperthermia. 2019;36(1):835-840. doi: 10.1080/02656736.2019.1645365.

Abstract

To compare the clinical efficacy of ultrasound-guided percutaneous microwave ablation (MWA) and parathyroidectomy for primary hyperparathyroidism. In an observational retrospective study, we compared the outcomes in patients with primary hyperparathyroidism who underwent ultrasound-guided MWA with the outcomes in those who underwent surgical resection (SR). The primary outcome was cure rate. Secondary outcomes were the rate of complications, and the difference of the treatment parameters of two treatment methods. Propensity-score matching was used to assemble a cohort of patients with similar baseline characteristics. Among 108 patients who met inclusion criteria, 28 patients who underwent ultrasound-guided MWA (MWA group) and 28 who underwent SR (SR group) had similar propensity scores and were included in the analyses. There was no significant difference in the cure rate between MWA group and SR group (82.1% vs. 89.3%,  = .705). Patients who underwent MWA had significantly less estimated blood loss and shorter surgical time than those who underwent SR ( < .001). The incidence of side effects and complications was comparable between MWA group and SR group (21.4% vs. 25%,  = .752). MWA and SR provided comparable short-term results in terms of cure rate and complications in treatment of primary hyperparathyroidism. Ultrasound-guided percutaneous MWA is a promising and minimally invasive method for primary hyperparathyroidism.

摘要

比较超声引导经皮微波消融(MWA)与甲状旁腺切除术治疗原发性甲状旁腺功能亢进症的临床疗效。在一项观察性回顾性研究中,我们比较了接受超声引导 MWA 的原发性甲状旁腺功能亢进症患者与接受手术切除(SR)的患者的结局。主要结局是治愈率。次要结局是并发症发生率以及两种治疗方法的治疗参数差异。采用倾向评分匹配法将具有相似基线特征的患者队列组合在一起。在符合纳入标准的 108 例患者中,28 例接受超声引导 MWA(MWA 组)和 28 例接受 SR(SR 组)的患者具有相似的倾向评分,并纳入分析。MWA 组和 SR 组的治愈率无显著差异(82.1% vs. 89.3%, = .705)。与 SR 组相比,接受 MWA 的患者的估计出血量和手术时间明显减少( < .001)。MWA 组和 SR 组的不良反应和并发症发生率相当(21.4% vs. 25%, = .752)。在治疗原发性甲状旁腺功能亢进症方面,MWA 和 SR 在治愈率和并发症方面均提供了相当的短期结果。超声引导经皮 MWA 是治疗原发性甲状旁腺功能亢进症的一种有前途的微创方法。

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