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单纯微波消融与微波联合乙醇消融治疗不同类型良性混合性甲状腺结节的比较。

Comparison of microwave alone and combined with ethanol ablation for different types of benign mixed thyroid nodules.

机构信息

Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.

Department of Ultrasound, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.

出版信息

Endocrine. 2023 Nov;82(2):361-367. doi: 10.1007/s12020-023-03437-0. Epub 2023 Jul 5.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of microwave ablation (MWA) plus ethanol ablation (EA) for different types of benign mixed thyroid nodules.

METHODS

A total of 81 patients with 81 benign mixed thyroid nodules were enrolled into the study; 39 were divided to the MWA group and 42 to the combined group (MWA combined with EA). Nodule ablation rate, volume reduction rate (VRR) and surgical complications of all patients were analyzed before and after treatment.

RESULTS

The mean ablation rate were 86.49 ± 6.68% and 90.09 ± 5.79% in the microwave and combined groups respectively, and the ablation rate of nodule decreased as the nodule volume increased. For nodules ≥15 ml in volume, the mean ablation rate of the combined group was higher than that of the microwave group (all P < 0.05). The mean VRR at 12 months postoperatively was 89.58 ± 4.32% in the microwave group and 92.92 ± 3.49% in the combined group, showing statistical significantly different between both arms (P = 0.001). The combined group decreased in volume more significantly than the microwave group for nodules with 20-50% or 50-80% cystic proportions or >15 ml in volume (all P < 0.05). The complication rate was 23.08% and 2.38% respectively.

CONCLUSION

MWA combined with EA is more effective than MWA for treating mixed thyroid nodules. MWA combined with EA may be the first approach for nodules with >20% cystic proportions or volume >15 ml.

摘要

目的

评估微波消融(MWA)联合乙醇消融(EA)治疗不同类型良性混合性甲状腺结节的疗效和安全性。

方法

共纳入 81 例 81 个良性混合性甲状腺结节患者,其中 39 例患者分为 MWA 组,42 例患者分为联合组(MWA 联合 EA)。分析所有患者治疗前后的结节消融率、体积缩小率(VRR)和手术并发症。

结果

微波组和联合组的平均消融率分别为 86.49±6.68%和 90.09±5.79%,随着结节体积的增加,结节的消融率降低。对于体积≥15ml 的结节,联合组的平均消融率高于微波组(均 P<0.05)。微波组术后 12 个月的平均 VRR 为 89.58±4.32%,联合组为 92.92±3.49%,两组之间差异有统计学意义(P=0.001)。对于 20%-50%或 50%-80%囊性比例或体积>15ml 的结节,联合组的体积缩小更为显著(均 P<0.05)。并发症发生率分别为 23.08%和 2.38%。

结论

与 MWA 相比,MWA 联合 EA 治疗混合性甲状腺结节更有效。对于囊性比例>20%或体积>15ml 的结节,MWA 联合 EA 可能是首选方法。

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