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超声引导下微波消融、激光消融与射频消融治疗老年良性甲状腺结节的疗效比较:Meta 分析。

Comparison of ultrasound-guided microwave ablation, laser ablation, and radiofrequency ablation for the treatment of elderly patients with benign thyroid nodules: A meta-analysis.

机构信息

Department of Ultrasound, The People's Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu, China.

Department of Endocrinology, The People's Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu, China.

出版信息

Exp Gerontol. 2024 Jun 15;191:112425. doi: 10.1016/j.exger.2024.112425. Epub 2024 Apr 18.

Abstract

BACKGROUND

A new minimally invasive technique, ultrasound-guided thermal ablation has become one of the treatment methods for benign thyroid nodules. This study aims to evaluate the efficacy and safety of laser ablation (LA), radiofrequency ablation (RFA), and microwave ablation (MWA) in the treatment of elderly patients with benign thyroid nodules.

METHODS

PubMed, Web of Science, and Cochrane Library were searched for qualified randomized controlled studies (RCTs) issued from establishing databases to March 2022. After screening and evaluating the article quality, the data on nodular volume reduction rate (VRR) and the incidence of complications after thermal ablation were extracted and analyzed by RevMan 5.3 and Stata l4.0.

RESULTS

The meta-analysis included seven articles with 3055 participants. We found that LA, RFA, and MWA could markedly reduce the volume of benign thyroid nodules. LA was superior to RFA and MWA in reducing the volume of benign thyroid nodules in 6 months of follow-up (all P < 0.05). LA, RFA, and MWA can be safely implemented in patients with benign thyroid nodules. The incidence of significant complications after the RFA group was enhanced compared with that in the MWA (P < 0.05), and the incidence of secondary complications after RFA was slightly higher than that of LA (P < 0.05).

CONCLUSION

LA, RFA, and MWA can markedly reduce the volume of benign thyroid nodules in elderly patients and can safely treat benign thyroid nodules.

摘要

背景

一种新的微创技术,超声引导热消融已成为治疗良性甲状腺结节的方法之一。本研究旨在评估激光消融(LA)、射频消融(RFA)和微波消融(MWA)治疗老年良性甲状腺结节的疗效和安全性。

方法

检索PubMed、Web of Science 和 Cochrane Library 数据库,收集从建库至 2022 年 3 月发表的关于 LA、RFA 和 MWA 治疗老年良性甲状腺结节的随机对照试验(RCT)。筛选并评价文献后,应用 RevMan 5.3 和 Stata l4.0 软件提取并分析热消融后结节体积缩小率(VRR)和并发症发生率的数据。

结果

纳入 7 篇文献,共 3055 例患者。Meta 分析结果显示,LA、RFA 和 MWA 均能显著缩小良性甲状腺结节体积,LA 在术后 6 个月缩小良性甲状腺结节体积优于 RFA 和 MWA(均 P<0.05)。LA、RFA 和 MWA 治疗良性甲状腺结节安全有效。RFA 组治疗后严重并发症发生率高于 MWA 组(P<0.05),RFA 组治疗后发生二级并发症的风险略高于 LA 组(P<0.05)。

结论

LA、RFA 和 MWA 能显著缩小老年患者良性甲状腺结节体积,安全有效,治疗良性甲状腺结节疗效确切。

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