超声造影在激光消融治疗甲状腺结节中的应用效果

摘要

Objective To investigate the efficacy of contrast-enhanced ultrasonography applied to laser ablation for thyroid nodules. Methods Ninety-four patients with thyroid nodules were randomly divided into observation group and control group,with 47 cases in each group.Contrast-enhanced ultrasoography-guided laser ablation and conventional laser ablation were conducted in the observation group and control group respectively.The rate of complete ablation,regression rates of nodules at 3 and 6 months after operation,incidence of complications at 6 months after operation,serum free triiodothyronine(FT3) and free thyroxine(FT4) levels were compared between the two groups. Results Ablation was completed in all cases.The rate of complete ablation,regression rates of nodules at 3 and 6 months after operation in the observation group were higher than those in the control group(P <0.05). At postoperative 6 month,the total incidence rate of complications,including laryngeal nerve injury,hoarseness and neck pain,in the observation group was lower than that in the control group (P<0.05).At postoperative 6 month,the FT3and FT4levels in the control group were significantly lower than the preoperative levels (P<0.05),but no significant difference was observed between the preoperative and postoperative levels in the observation group(P>0.05). Conclusion Contrast-enhanced ultrasonography can achieve real-time monitoring,improve the therapeutic efficacy of laser ablation for thyroid nodules and the regression rate of nodules,has little effect on thyroid function,and can also reduce the incidence of complications.%目的 探讨超声造影在激光消融治疗甲状腺结节中的应用效果.方法 将94例甲状腺结节患者随机分为观察组与对照组各47例,观察组在甲状腺超声造影指导下行激光消融治疗,对照组采用传统激光消融治疗.比较两组的消融完全率、术后3个月及6个月的结节缩小率、术后6个月并发症发生情况,血清游离三碘甲腺原氨酸(FT3)及游离甲状腺素(FT4)水平.结果 94例患者都完成消融,观察组的完全消融率、术后3个月及6个月的结节缩小率均高于对照组(P<0.05).观察组术后6个月的喉返神经损伤、声音嘶哑、颈部疼痛等并发症总发生率低于对照组(P<0.05).对照组术后6个月的FT3、FT4水平明显低于术前(P<0.05),而观察组的FT3、FT4水平与术前比较差异无统计学意义(P>0.05).结论 超声造影能实现实时监测,提高激光消融治疗甲状腺结节的疗效及结节缩小率,对甲状腺功能的影响比较小,并可减少并发症的发生.