超声引导下射频与微波消融治疗甲状腺良性结节的比较

摘要

Objective To discuss the comparative values of radiofrequency ablation and microwave ablation in the treatment of benign thyroid nodules.Methods From August 2013 to January 2017,92 patients with benign thyroid nodules in Tangshan People's Hospital were selected and divided into observation group and control group by random number table,with 46 cases in each group.The control group was treated by ultrasound guided radiofrequency ablation therapy,and the observation group was treated by ultrasound guided microwave ablation treatment.The prognosis in the two groups were recorde.Results All patients were completed the ablation successfully.After treatment,the total effective rates of the observation group and the control group were 87％ and 82.6％ respectively,and there was no significant difference compared between the two groups (P ＞ 0.05).Three days after treatment,incidence rates of hepatic dysfunction in observation group and control group were 4.3％ and 17.4％ respectively,and the incidence of the observation group was lower than that of the control group (P ＜ 0.05).Fourteen days after treatment,the serum TT3 and TT4 values of the observation group and the control group were significantly higher than before treatment (P ＜ 0.05),and the values of the observation group were higher than those of the control group (P ＜ 0.05).Three months after treatment,the total complication incidence rate in the observation group was 6.5％,26.1％ in the control group,so the observation group was significantly lower than the control group (P ＜ 0.05).Conclusion Compares with ultrasound guided radiofrequency ablation,microwave ablation of benign thyroid nodules has good ablation effect.It can promote thyroid hormone secretion,reduce liver damage,reduce the incidence of complications,and it has very good application values.%目的 比较超声引导下射频与微波消融治疗甲状腺良性结节的临床效果.方法 选择2013年8月～2017年1月在唐山市人民医院诊治的92例甲状腺良性结节患者作为研究对象,按随机数字表法分为观察组与对照组,每组各46例.对照组给予超声引导下射频消融治疗,观察组给予超声引导下微波消融治疗,记录两组治疗效果.结果 所有患者都顺利完成消融,治疗后观察组与对照组的消融总有效率分别为87.0％和82.6％,差异无统计学意义(P＞0.05).观察组与对照组治疗后3d的肝功能损害发生率分别为4.3％和17.4％,观察组肝功能损害发生率低于对照组(P＜0.05).观察组与对照组治疗后14 d的血清总三碘甲腺原氨酸(TT3)、总甲状腺素(TT4)值明显高于治疗前(P＜0.05),同时治疗后14d观察组的血清TT3与TT4值明显高于对照组(P＜0.05).观察组治疗后3个月的并发症发生率为6.5％,对照组为26.1％,观察组明显低于对照组(P＜0.05).结论 超声引导下微波消融治疗甲状腺良性结节也具有很好的消融效果,能促进甲状腺激素分泌正常,减少对肝功能的损伤,降低并发症的发生,有很好的应用价值.