高强度聚焦超声（HIFU）治疗良性甲状腺结节的疗效与安全性：一项系统评价和荟萃分析
Efficacy and safety of high-intensity focused ultrasound (HIFU) for treating benign thyroid nodules: a systematic review and meta-analysis.
作者信息
Chung Sae Rom, Baek Jung Hwan, Suh Chong Hyun, Choi Young Jun, Lee Jeong Hyun
机构信息
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
出版信息
Acta Radiol. 2020 Dec;61(12):1636-1643. doi: 10.1177/0284185120909339. Epub 2020 Mar 22.
BACKGROUND
High-intensity focused ultrasound (HIFU) is an emerging thermal ablation technique that has been successfully applied to various benign thyroid nodules.
PURPOSE
To evaluate the efficacy and safety of HIFU for the treatment of benign thyroid nodules.
MATERIAL AND METHODS
The Ovid-MEDLINE and EMBASE databases were searched up to 9 July 2018 for studies describing the use of HIFU to treat benign thyroid nodules. We included studies that have outcomes with sufficient detail to evaluate the volume reduction rate (VRR). The pooled proportions of VRR ≥50% and pooled VRR at one, three, and six months after HIFU were assessed using random-effects modeling. Heterogeneity among studies was determined using Chi-square statistics for pooled estimates and the inconsistency index I.
RESULTS
Seven studies were included in the systematic review and four in the meta-analysis. The pooled VRR at one, three, and six months after HIFU were 17.59 (95% confidence interval [CI] 12.56-22.62), 48.93 (95% CI 42.20-55.66), and 60.43 (95% CI 51.88-68.98). The pooled proportions of VRR ≥50% at six months after HIFU were 75% (95% CI 53-89; I=73.6%). There were no major complications of HIFU.
CONCLUSION
HIFU may be a safe and effective treatment modality for benign thyroid nodules, especially for small nodules.
背景
高强度聚焦超声（HIFU）是一种新兴的热消融技术，已成功应用于各种良性甲状腺结节。
目的
评估HIFU治疗良性甲状腺结节的疗效和安全性。
材料与方法
检索截至2018年7月9日的Ovid-MEDLINE和EMBASE数据库，查找描述使用HIFU治疗良性甲状腺结节的研究。我们纳入了具有足够详细结果以评估体积缩小率（VRR）的研究。使用随机效应模型评估HIFU后1个月、3个月和6个月时VRR≥50%的合并比例以及合并VRR。使用卡方统计量进行合并估计和不一致指数I来确定研究之间的异质性。
结果
系统评价纳入7项研究，荟萃分析纳入4项研究。HIFU后1个月、3个月和6个月时的合并VRR分别为17.59（95%置信区间[CI]12.56 - 22.62）、48.93（95%CI 42.20 - 55.66）和60.43（95%CI 51.88 - 68.98）。HIFU后6个月时VRR≥50%的合并比例为75%（95%CI 53 - 89；I = 73.6%）。HIFU没有重大并发症。
结论
HIFU可能是治疗良性甲状腺结节，尤其是小结节的一种安全有效的治疗方式。
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