超声引导下乙醇消融与射频消融治疗甲状腺囊实性结节的疗效对比研究

摘要

目的 探讨超声引导下乙醇消融与射频消融治疗甲状腺囊实性结节方面的疗效比较.方法 选取我院接受超声引导下乙醇消融或射频消融的患有单个甲状腺囊实性结节的患者95例,依据患者接受治疗方法的不同,可将其分为乙醇组(n=46)和射频组(n=49).于术后3、6、9、12个月观测甲状腺结节体积缩小情况,以及不同囊实性比例及患者出现不良反应情况.结果 术后3、6、9、12个月,射频组甲状腺结节体积缩小率均明显大于乙醇组,且以术后12个月缩小最为显著,差异均有统计学意义(均P85%,且均明显大于乙醇组,差异均有统计学意义(均P30 ml时,乙醇组术后12个月体积缩小率不足50%,治疗无效.两组患者结节术后体积缩小率均随囊实性比例的减小而减小,且射频组体积缩小率均大于乙醇组,差异均有统计学意义(均P50%,应首选乙醇消融治疗;而对于体积>30 ml或囊实性比例<50%的结节,射频消融术治疗为首选.%Objective To investigate the efficacy of ultrasound-guided ethanol ablation and radiofrequency ablation in the treatment of thyroid cystic solid nodules. Methods Ninety-five patients with single thyroid cystic nodule who underwent ultrasound-guided ethanol ablation or radiofrequency catheter ablation in our hospital were selected. These patients were divided into ethanol group(n=46) and radiofrequency group(n=49) according to the different treatment methods. At 3,6,9 and 12 months after treatment,the volume reduction of thyroid nodules,the proportion of cystic and solidity in the nodules,and the adverse reactions of the two groups of patients were analyzed and compared. Results The volume reduction rate of thyroid nodules in radiofrequency group was significantly higher than that of ethanol group at 3,6,9 and 12 months after operation,and there was significant difference at 12 months after operation(all P<0.05). The volume reduction rate of thyroid nodules in different volume in radiofrequency group was more than 85%which was significantly higher than that of ethanol group,there was difference(all P<0.05). When the volume of nodules was greater than 30 ml,the volume reduction rate of ethanol group at 12 month after operation was less than 50%,and the treatment was invalid. With the reduction ratio of cystic to solidity,the nodules volume reduction rate of thyroid nodules in both groups decreased,and the nodule volume reduction rate in radiofrequency group was significantly higher than that of the ethanol group,there was difference(all P<0.05).When the cystic to solidity ratio was less than 50%,the volume reduction rate of ethanol group was less than 50%,and the treatment was invalid. There was no significant difference in adverse reactions between the two groups. Conclusion Ethanol ablation is an economic and effective method in the treatment of thyroid cystic solid nodule is less than 30 ml,and cystic solid ratio is more than 50%. While the radiofrequency ablation should be preferred when thyroid cystic solid nodule is more than 30 ml,and cystic solid ratio is less than 50%.