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微波消融与射频消融治疗良性甲状腺结节的安全性和疗效的倾向评分匹配研究。

A Propensity Score Matching Study Between Microwave Ablation and Radiofrequency Ablation in Terms of Safety and Efficacy for Benign Thyroid Nodules Treatment.

机构信息

The Second Department of General Surgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China.

Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China.

出版信息

Front Endocrinol (Lausanne). 2021 Mar 9;12:584972. doi: 10.3389/fendo.2021.584972. eCollection 2021.

Abstract

BACKGROUND

Large benign thyroid nodules often lead to cosmetic problems and compression on trachea. Thermal ablation is an effective method for benign thyroid nodules treatment. Among all the thermal ablation techniques, microwave and radiofrequency are frequently used energy sources. However, treatment outcomes of the two ablation types have not been compared in detail. Therefore, we conducted this study aiming for comparing the safety and efficacy of the two ablation techniques in benign thyroid nodules treatment.

METHODS

Information was retrospectively collected from patients with benign thyroid nodules, who received radiofrequency ablation or microwave ablation between January 1, 2018, and December 31, 2019, in a main hospital in South China. Patients were divided into microwave ablation group and radiofrequency ablation group according to the techniques applied. A propensity score matching was performed to balance the baseline indexes between the two groups. We also recorded and analyzed the operative variables including operative duration, intraoperative blood loss, hospitalization time, and overall costs. Postoperative quality of life, volume reduction rates, and complication rates were routinely evaluated during the follow-up by asking patients to fulfil questionnaires at the 1, 3, 6, 12, and 18 postoperative month.

RESULTS

A total of 943 patients receiving microwave ablation or radiofrequency ablation in the years of 2018 and 2019 met our inclusion criteria. After 1:1 propensity score matching, 289 pairs of patients were matched. There was no significant difference between the two groups in operative duration, intraoperative blood loss, hospitalization time, overall cost, quality of life scores, complication rates or volume reduction rates.

CONCLUSION

There was no significant difference between microwave and radiofrequency ablation in terms of safety and efficacy. Both of the two techniques` are ideal therapeutic methods in benign thyroid nodules treatment.

REGISTRATION NUMBER

ChiCTR2000034764.

摘要

背景

大的良性甲状腺结节常导致美容问题和气管压迫。热消融是治疗良性甲状腺结节的有效方法。在所有热消融技术中,微波和射频是常用的能量源。然而,这两种消融类型的治疗效果尚未详细比较。因此,我们进行了这项研究,旨在比较两种消融技术治疗良性甲状腺结节的安全性和疗效。

方法

回顾性收集 2018 年 1 月 1 日至 2019 年 12 月 31 日期间在华南某医院接受射频消融或微波消融治疗的良性甲状腺结节患者的资料。根据应用的技术,患者分为微波消融组和射频消融组。采用倾向评分匹配法使两组的基线指标平衡。我们还记录和分析了手术变量,包括手术时间、术中出血量、住院时间和总费用。术后通过让患者在术后 1、3、6、12 和 18 个月填写问卷,常规评估术后生活质量、体积减少率和并发症发生率。

结果

2018 年和 2019 年共有 943 例接受微波消融或射频消融的患者符合纳入标准。经过 1:1 倾向评分匹配后,匹配了 289 对患者。两组在手术时间、术中出血量、住院时间、总费用、生活质量评分、并发症发生率或体积减少率方面无显著差异。

结论

微波和射频消融在安全性和疗效方面没有显著差异。这两种技术都是治疗良性甲状腺结节的理想方法。

注册号

ChiCTR2000034764。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7be4/7985541/47dcf0550755/fendo-12-584972-g001.jpg

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