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超声引导下热消融治疗格雷夫斯病的疗效与安全性:一项回顾性队列研究。

Efficacy and safety of ultrasound-guided thermal ablation of graves' disease: a retrospective cohort study.

作者信息

Cai Guangzhen, Luo Beilin, Wang Maolin, Su Jiqin, Lin Luping, Li Guibin, Chen Xiangru, Huang Zhishu, Lin Peiyi, Liu Shengwei, Yan Huidi, Zhou Lixin

机构信息

Department of General Surgery, The Second Affiliated Hospital of Xiamen Medical College, 566#, Shengguang Road, 361021, Xiamen, P.R. China.

The Graduate School of Fujian Medical University, The Second Affiliated Hospital of Xiamen Medical College, 88#, Jiaotong Road, 350005, Fuzhou, P.R. China.

出版信息

Thyroid Res. 2024 Jun 3;17(1):10. doi: 10.1186/s13044-024-00198-4.

Abstract

BACKGROUND

Ultrasound-guided thermal ablation (TA) has emerged as a robust therapeutic approach for treating solid tumors in multiple organs, including the thyroid. Yet, its efficacy and safety profile in the management of Graves' Disease (GD) remains to be definitively established.

METHODS

A retrospective study was conducted on 50 GD patients treated with TA between October 2017 and December 2021. Key metrics like thyroid volume, volume reduction rate (VRR), thyroid hormones, and basal metabolic rate (BMR) were evaluated using paired Wilcoxon tests.

RESULTS

The intervention of ultrasound-guided TA yielded a statistically significant diminution in total thyroid volume across all postoperative follow-up intervals-1, 3, 6, and 12 months-relative to pre-intervention baselines (p < 0.001). The median VRR observed at these time points were 17.5%, 26.5%, 34.4%, and 39.8%, respectively. Euthyroid status was corroborated in 96% of patients at the one-year follow-up milestone. Transient tachycardia and dysphonia were observed in three patients, while a solitary case of skin numbness was noted. Crucially, no instances of enduring injury to the recurrent laryngeal nerve (RLN) were documented.

CONCLUSIONS

Our investigation substantiates ultrasound-guided TA as a pragmatic, well-tolerated, and safe therapeutic modality for GD. It effectively improves symptoms of hyperthyroidism, engenders a substantial reduction in thyroid volume, and restores thyroid hormone and BMR to physiological levels. Given its favorable safety profile, enhanced cosmetic outcomes, and minimally invasive nature, ultrasound-guided TA is a compelling alternative to thyroidectomy for GD patients.

摘要

背景

超声引导下热消融(TA)已成为治疗包括甲状腺在内的多个器官实体瘤的一种可靠治疗方法。然而,其在格雷夫斯病(GD)治疗中的疗效和安全性仍有待明确确定。

方法

对2017年10月至2021年12月期间接受TA治疗的50例GD患者进行回顾性研究。使用配对威尔科克森检验评估甲状腺体积、体积缩小率(VRR)、甲状腺激素和基础代谢率(BMR)等关键指标。

结果

超声引导下TA干预后,在所有术后随访间隔(1、3、6和12个月),相对于干预前基线,甲状腺总体积在统计学上显著减小(p < 0.001)。在这些时间点观察到的VRR中位数分别为17.5%、26.5%、34.4%和39.8%。在一年随访里程碑时,96%的患者甲状腺功能正常得到证实。3例患者出现短暂性心动过速和声音嘶哑,同时记录到1例皮肤麻木病例。至关重要的是,没有记录到喉返神经(RLN)的永久性损伤病例。

结论

我们的研究证实超声引导下TA是一种实用、耐受性良好且安全的GD治疗方式。它有效改善甲亢症状,使甲状腺体积大幅减小,并将甲状腺激素和BMR恢复到生理水平。鉴于其良好的安全性、更好的美容效果和微创性质,超声引导下TA是GD患者甲状腺切除术的一种有吸引力的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6c4/11145836/6d42de7338e2/13044_2024_198_Fig1_HTML.jpg

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