Fu Yuehe, Xia Yuke, Wang Haiyan, Zhang Gong
Yuehe Fu Department of Thyroid and Breast Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, 169 Hushan Road, Nanjing, Jiangsu Province 211100, P.R. China.
Yuke Xia Department of Thyroid and Breast Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, 169 Hushan Road, Nanjing, Jiangsu Province 211100, P.R. China.
Pak J Med Sci. 2024 Aug;40(7):1367-1371. doi: 10.12669/pjms.40.7.9486.
To compare the effectiveness of ultrasound (US)-guided radiofrequency ablation (RFA) and conventional open thyroidectomy (OT) in the treatment of benign thyroid nodules (BTN).
Medical records of 103 patients with BTN undergoing surgical treatment at The Affiliated Jiangning Hospital of Nanjing Medical University from March 2019 to March 2022 were retrospectively analyzed. Records show that 53 patients underwent US-guided RFA (observation group) and 50 patients underwent conventional OT (control group). Perioperative indicators (operation duration, intraoperative blood loss, postoperative hospital stay, incision length, and VAS score 12h and 24h after surgery), complications, thyroid function, and nodule recurrence in both groups were compared and analyzed.
Perioperative indicators of patients in the observation group were better, and the visual analogue scale (VAS) scores at 12 and 24 hours after the surgery were lower than those of the control group (<0.05). The incidence of complications in the observation group was significantly lower than that in the control group (<0.05). There was no statistically significant difference in the preoperative levels of thyroid-stimulating hormone (TSH), serum free thyroxine (FT4) and serum free triiodothyronine (FT3) between the two groups (>0.05). The postoperative TSH levels in the observation group increased compared to the preoperative levels and were higher than those in the control group, while FT4 and FT3 levels decreased after surgery and were lower than those in the control group (<0.05).
Compared to conventional open thyroidectomy, US-guided RFA is associated with less trauma, faster recovery, fewer complications, and less impact on thyroid function in the treatment of patients with BTN.
比较超声(US)引导下射频消融(RFA)与传统开放性甲状腺切除术(OT)治疗良性甲状腺结节(BTN)的有效性。
回顾性分析2019年3月至2022年3月在南京医科大学附属江宁医院接受手术治疗的103例BTN患者的病历。记录显示,53例患者接受了US引导下的RFA(观察组),50例患者接受了传统OT(对照组)。比较并分析两组患者的围手术期指标(手术时间、术中出血量、术后住院时间、切口长度以及术后12小时和24小时的视觉模拟评分[VAS])、并发症、甲状腺功能和结节复发情况。
观察组患者的围手术期指标较好,术后12小时和24小时的视觉模拟量表(VAS)评分低于对照组(<0.05)。观察组并发症发生率显著低于对照组(<0.05)。两组术前促甲状腺激素(TSH)、血清游离甲状腺素(FT4)和血清游离三碘甲状腺原氨酸(FT3)水平差异无统计学意义(>0.05)。观察组术后TSH水平较术前升高,且高于对照组,而术后FT4和FT3水平降低,低于对照组(<0.05)。
与传统开放性甲状腺切除术相比,US引导下的RFA在治疗BTN患者时创伤更小、恢复更快、并发症更少,对甲状腺功能的影响也更小。