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热消融治疗大型良性甲状腺结节的疗效和安全性的荟萃分析。

Meta-analysis of the efficacy and safety of thermal ablation for treating large benign thyroid nodules.

机构信息

Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, China.

出版信息

Clin Endocrinol (Oxf). 2022 Nov;97(5):654-663. doi: 10.1111/cen.14695. Epub 2022 Mar 6.

Abstract

OBJECTIVE

Many large benign thyroid nodules have symptoms and cosmetic problems. This study consisted of a meta-analysis to accurately assess the effect of thermal ablation on these nodules.

METHODS

The PubMed, Embase, Web of Science, and Scopus databases were systematically searched for retrospective or prospective studies of thermal ablation since June 1, 2021. The weighted mean differences of the measures were analysed before and after treatment.

RESULTS

A total of 10 eligible studies were included. By comparing the initial nodule volume with the nodular volume after thermal ablation, we found that the volume reduction rate was increased significantly after 1 month (SMD = 0.453, 95% CI: 0.323-0.583, p < .001), 3 months (SMD = 0.655, 95% CI: 0.563-0.747, p < .001), 6 months (SMD = 0.691, 95% CI: 0.607-0.774, p < .001), and 12 months (SMD = 0.694, 95% CI: 0.583-0.803), p < .001). The nodular volume was also found to decrease significantly, after 1 month (SMD = 2.381, 95% CI: 1.278-3.485, p < .001), 3 months (SMD = 5.071, 95% CI: 2.386-7.756, p < .001), 6 months (SMD = 5.363, 95% CI: 2.765-7.962, p < .001), and 12 months (SMD = 8.194, 95% CI: 2.113-14.274), p < .001). Symptom score (SMD = 4.419, 95% CI: 2.573-6.265, p < .001)and cosmetic score (SMD = 4.245, 95% CI: 2.566-5.359, p < .001) were reduced after thermal ablation.

CONCLUSIONS

Thermal ablation could become an alternative to manage large benign thyroid nodules.

摘要

目的

许多大型良性甲状腺结节存在症状和美容问题。本研究进行了一项荟萃分析,以准确评估热消融对这些结节的疗效。

方法

系统检索了 2021 年 6 月 1 日以来关于热消融的回顾性或前瞻性研究的 PubMed、Embase、Web of Science 和 Scopus 数据库。治疗前后分析了测量指标的加权均数差值。

结果

共纳入 10 项符合条件的研究。通过比较初始结节体积与热消融后的结节体积,我们发现 1 个月(SMD=0.453,95%CI:0.323-0.583,p<0.001)、3 个月(SMD=0.655,95%CI:0.563-0.747,p<0.001)、6 个月(SMD=0.691,95%CI:0.607-0.774,p<0.001)和 12 个月(SMD=0.694,95%CI:0.583-0.803,p<0.001)时结节体积减少率显著增加,p<0.001)。治疗后 1 个月(SMD=2.381,95%CI:1.278-3.485,p<0.001)、3 个月(SMD=5.071,95%CI:2.386-7.756,p<0.001)、6 个月(SMD=5.363,95%CI:2.765-7.962,p<0.001)和 12 个月(SMD=8.194,95%CI:2.113-14.274,p<0.001)时结节体积也显著减少。症状评分(SMD=4.419,95%CI:2.573-6.265,p<0.001)和美容评分(SMD=4.245,95%CI:2.566-5.359,p<0.001)在热消融后降低。

结论

热消融可能成为治疗大型良性甲状腺结节的一种替代方法。

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