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改良经皮乙醇注射法联合微波消融治疗症状性、以囊肿为主的良性甲状腺结节:201 例回顾性研究。

Modified percutaneous ethanol injection method combined with microwave ablation for the treatment of symptomatic, predominantly cystic, benign thyroid nodules: a retrospective study of 201 cases.

机构信息

Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.

出版信息

Int J Hyperthermia. 2021;38(1):995-1001. doi: 10.1080/02656736.2021.1924407.

Abstract

OBJECTIVE

Percutaneous ethanol injection (PEI) and microwave ablation (MWA) are both important methods used in treating benign thyroid nodules. This study aimed to investigate the efficacy and safety of a modified PEI method combined with MWA for the treatment of symptomatic, predominantly cystic and benign thyroid nodules.

MATERIALS AND METHODS

This study included 201 patients who underwent treatment in our department between April 2015 and August 2018. Predominantly cystic thyroid nodules were treated by the modified PEI procedure, which included short-term boiling ethanol ablation (STBEA) and was combined with MWA. Complications, the volume reduction ratio (VRR), symptoms and cosmetic scores were recorded at 1, 3, 6 and 12 months after treatment and every 6 months thereafter.

RESULTS

No major complications were observed during or after the treatment. Ten patients (4.8%) experienced temporary voice change, which resolved within 3 months. Of 200 (97.6%) out of 205 nodules showed significant volume reduction at the final follow-up. Recurrence occurred for only 5 (2.4%) nodules. The mean thyroid nodule volume decreased from 17.40 ± 3.21 mL at baseline to 1.17 ± 0.37 mL at 12 months. The greatest VRR was observed within the first 3 months after treatment.

CONCLUSIONS

The modified PEI method combined with MWA is safe and effective for the treatment of predominantly cystic benign thyroid nodules and provides a shorter operating time and lower recurrence rate than traditional treatments.

摘要

目的

经皮乙醇注射(PEI)和微波消融(MWA)都是治疗良性甲状腺结节的重要方法。本研究旨在探讨改良 PEI 联合 MWA 治疗症状性、以囊性为主的良性甲状腺结节的疗效和安全性。

材料和方法

本研究纳入 201 例于 2015 年 4 月至 2018 年 8 月在我科接受治疗的患者。主要囊性甲状腺结节采用改良的 PEI 方法治疗,包括短期煮沸乙醇消融(STBEA),并结合 MWA。记录治疗后 1、3、6 和 12 个月及此后每 6 个月的并发症、体积减少率(VRR)、症状和美容评分。

结果

治疗过程中和治疗后无重大并发症。10 例(4.8%)患者出现暂时性声音改变,3 个月内恢复。205 个结节中有 200 个(97.6%)显示出显著的体积减小,最终随访时仅 5 个(2.4%)结节复发。甲状腺结节平均体积从基线时的 17.40±3.21ml 减少到 12 个月时的 1.17±0.37ml。最大 VRR出现在治疗后 3 个月内。

结论

改良 PEI 联合 MWA 治疗以囊性为主的良性甲状腺结节安全有效,与传统治疗相比,操作时间更短,复发率更低。

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