目的探讨超声引导下经皮激光消融甲状腺良性实性结节的方法、安全性及近期疗效。方法治疗组12例单发甲状腺良性实性结节行超声引导下激光消融治疗，术后采用常规超声随访观察结节大小、血供，采用超声造影评价病灶消融范围，并观察并发症的发生情况及监测甲状腺功能。对照组12例单发甲状腺良性实性结节未经任何治疗，随访方法及时间与治疗组相同。结果治疗组12例患者均成功进行了激光消融治疗，术后超声随访结节的体积较术前逐渐缩小（P<0.05），血流信号消失。术后即刻超声造影显示11例结节呈无增强，完全消融率为91.7%。术中难忍受的疼痛3例，适当处理后疼痛减轻或消失。治疗前、后检测甲状腺功能无明显变化（P>0.05）。对照组随访6个月结节体积及甲功均无明显变化（P>0.05）。结论超声引导下经皮激光消融术是治疗甲状腺良性结节的安全、有效方法，治疗后结节体积可逐渐缩小，在一定程度上对甲状腺功能并无明显影响。%Objective To evaluate the method, safety and short-term efficacy of ultrasound-guided percutaneous laser ablation (PLA) for benign solid thyroid nodule (BSTN). Methods The treatment group consisting of 12 patients with single BSTN were treated with ultrasound-guided PLA. After treatment, the size and blood flow signals in conventional ultrasonography, the ablation extent of lesions in contrast-enhanced ultrasonography (CEUS), and the related complications and thyroid function were assessed in comparison with the the baseline. A control group including 12 untreated patients with single BSTN was followed-up in the same manner as in the treatment group. Results In the treatment group, all the 12 patients completed the treatment successfully. During the follow-up, the volume of the nodules was reduced gradually (P<0.05), and blood flow signals in the nodules disappeared. Eleven nodules were non-enhanced in CEUS immediately after the treatment, and the complete ablation rate was 91.7%. During the operation, 3 patients complained of intolerable pain, which was ameliorated or totally relieved after appropriate treatment. The thyroid function showed no significant changes after the treatment (P>0.05). The control group followed up for 6 months showed no significant changes in the nodule volume or thyroid function in comparison with the baseline (P>0.05). Conclusion Ultrasound-guided PLA is a safe and effective minimally invasive treatment of BSTN without obvious adverse effect on thyroid function.
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