超声引导下经皮乙醇注射治疗甲状腺囊肿的疗效评估。

Long-term efficacy evaluation of a protocol for the management of symptomatic thyroid cysts with ultrasound-guided percutaneous ethanol injection.

机构信息

Endocrinology and Nutrition Service, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain; Department of Medicine, Autonomous University of Barcelona, Spain; CIBERER, Instituto Carlos III, Madrid, Spain.

Endocrinology and Nutrition Service, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain; Department of Medicine, Autonomous University of Barcelona, Spain.

出版信息

Endocrinol Diabetes Nutr (Engl Ed). 2021 Apr;68(4):236-242. doi: 10.1016/j.endinu.2020.07.004. Epub 2020 Nov 5.

DOI:10.1016/j.endinu.2020.07.004

PMID:33160949

Abstract

AIM

To evaluate the long-term efficacy of percutaneous ethanol injection treatment (PEIT) as an alternative to thyroid surgery in symptomatic thyroid cysts.

PATIENTS AND METHODS

100 subjects (48±12 years; 58% women) with symptomatic thyroid cysts relapsing after drainage were prospectively included. PEIT was conducted using an established procedure, and the initial cyst volume, symptoms and pain perceived by the patient were assessed. The volume of instilled alcohol was ≤2ml without re-extraction in all cases. Patients were followed-up for more than 3 years and final cyst volume and symptom improvement were assessed.

RESULTS

Mean maximum cyst diameter before drainage was 3.1±1.2cm. In 71% of patients ≤2 PEIT sessions were required. Median maximum cyst volume was 12.7 (5.4-21.7)ml before the first drainage and median total volume extracted from the cysts was 13.0 (6.2-37.0)ml. After a mean follow-up period of 52±10 months, 98% of patients reported a complete absence of symptoms. The final median volume for the whole group was 0.8 (0.1-2.0)ml with a median volume reduction of 94 (81-99)%. A final volume reduction greater than 65% was observed in 90% of cases. Reported pain during the procedure was absent or mild in 76.4% of cases.

CONCLUSIONS

PEIT is a safe and well-tolerated first-line treatment for symptomatic thyroid cysts with long-term effectiveness.

摘要

目的

评估经皮乙醇注射治疗（PEIT）作为甲状腺手术的替代方法治疗有症状甲状腺囊肿的长期疗效。

患者与方法

前瞻性纳入 100 例（48±12 岁；58%为女性）有症状的甲状腺囊肿患者，这些患者在引流后复发。采用既定的程序进行 PEIT，并评估初始囊肿体积、患者症状和感知的疼痛。所有情况下，注入的酒精体积均≤2ml，无需再次抽取。对患者进行了超过 3 年的随访，并评估了最终的囊肿体积和症状改善情况。

结果

引流前最大囊肿直径的平均值为 3.1±1.2cm。71%的患者需要≤2 次 PEIT 治疗。第一次引流前，中位数最大囊肿体积为 12.7（5.4-21.7）ml，从中抽出的囊肿总容量中位数为 13.0（6.2-37.0）ml。平均随访 52±10 个月后，98%的患者报告完全无症状。整个组的最终中位数体积为 0.8（0.1-2.0）ml，总体积减少 94（81-99）%。90%的病例观察到最终体积减少大于 65%。76.4%的病例在手术过程中报告无疼痛或轻度疼痛。