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射频消融治疗甲状腺叶切除术后良性甲状腺结节的疗效和安全性。

Efficacy and safety of radiofrequency ablation for benign thyroid nodules in patients with previous thyroid lobectomy.

机构信息

Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, China.

出版信息

BMC Med Imaging. 2021 Mar 11;21(1):47. doi: 10.1186/s12880-021-00577-5.

Abstract

BACKGROUND

Radiofrequency ablation (RFA) is recommended for the treatment of benign thyroid nodules. However, data on the clinical role of RFA for benign thyroid nodules in patients with history of thyroid lobectomy are insufficient. The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation (RFA) for benign thyroid nodules in patients who had previously undergoing thyroid lobectomy.

METHODS

From May 2015 to October 2018, a total of 20 patients (19 females, 1 male, mean age 49.50 ± 14.26 years, range 22-74 years) with 20 benign thyroid nodules (mean volume 15.04 ± 21.17 ml, range 0.40-69.67 ml) who had undergone previous thyroid lobectomy were included in this retrospective study. Patients were followed up at 3, 6, 12 months after RFA and every 12 months thereafter by ultrasound, clinical evaluation and thyroid function. Volume, volume reduction rate (VRR), symptom score and cosmetic score were evaluated.

RESULTS

During the mean follow-up time of 21.24 ± 16.41 months, the mean nodule volume decreased significantly from 15.04 ± 21.17 ml to 1.29 ± 1.17 ml (P = 0.018) with a mean VRR of 85.41 ± 12.17%. Therapeutic success was achieved in a single session for all thyroid nodules. The symptom score (P = 0.001) and cosmetic score (P = 0.001) were both significantly reduced at the last follow-up. The levels of free triiodothyronine (fT3), free thyroxine (fT4) and thyroid stimulating hormone were not significantly different at the last follow-up from those prior to treatment (all P > 0.05). No life-threatening complications or sequelae occurred after RFA.

CONCLUSIONS

As a minimally invasive modality, RFA was a safe, effective, and thyroid function-preserving option for patients with symptomatic benign thyroid nodules after a previous lobectomy.

摘要

背景

射频消融术(RFA)被推荐用于治疗良性甲状腺结节。然而,对于既往甲状腺叶切除术患者中 RFA 治疗良性甲状腺结节的临床作用的数据还不够充分。本研究的目的是评估射频消融术(RFA)治疗既往甲状腺叶切除术患者良性甲状腺结节的疗效和安全性。

方法

从 2015 年 5 月至 2018 年 10 月,共有 20 名(19 名女性,1 名男性,平均年龄 49.50±14.26 岁,范围 22-74 岁)20 个良性甲状腺结节(平均体积 15.04±21.17ml,范围 0.40-69.67ml)的患者被纳入这项回顾性研究。所有患者均在 RFA 治疗后 3、6、12 个月以及此后每年通过超声、临床评估和甲状腺功能进行随访。评估体积、体积减少率(VRR)、症状评分和美容评分。

结果

在平均 21.24±16.41 个月的随访期间,平均结节体积从 15.04±21.17ml 显著下降至 1.29±1.17ml(P=0.018),平均 VRR 为 85.41±12.17%。所有甲状腺结节均在单次治疗中达到治疗成功。最后一次随访时,症状评分(P=0.001)和美容评分(P=0.001)均显著降低。最后一次随访时游离三碘甲状腺原氨酸(fT3)、游离甲状腺素(fT4)和促甲状腺激素水平与治疗前相比均无显著差异(均 P>0.05)。RFA 后无危及生命的并发症或后遗症发生。

结论

作为一种微创治疗方法,RFA 是一种安全、有效且保留甲状腺功能的选择,适用于既往甲状腺叶切除术后有症状的良性甲状腺结节患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d7c/7948381/1be71eb06529/12880_2021_577_Fig1_HTML.jpg

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