| 郭卫红,刘曙艳.微波消融与手术切除治疗甲状腺良性结节疗效和机体应激反应程度的比较[J].安徽医药,2019,23(1):10-14. |
| 微波消融与手术切除治疗甲状腺良性结节疗效和机体应激反应程度的比较 |
| Comparison of microwave ablation and surgical resection on benign thyroid nodules and stress response |
| 投稿时间：2017-09-28 |
| DOI： |
| 中文关键词: 甲状腺结节 甲状腺切除术 微波 导管消融术 治疗结果 应激反应 |
| 英文关键词: Thyroid nodules Thyroidectomy Microwaves Catheter ablation Treatment outcome Stress response |
| 基金项目:河南省焦作市医学科研项目(2017KY040)◇甲状腺疾病◇微波消融与手术切除治疗甲状腺良性结节疗效和机体应激反应程度的比较 郭卫红1 ,刘曙艳2(1.河南理工大学第一附属医院焦作市第二人民医院,超声科,河南 焦作 45400;2.河南理工大学第一附属医院焦作市第二人民医院,内分泌科,河南 焦作 45400) |
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| 中文摘要: |
| 目的 比较分析超声引导下微波消融(MWA)与手术切除治疗甲状腺良性结节(BTN)的效果和安全性及对机体应激反应的影响。方法 选取2016年2月至2017年1月河南理工大学第一附属医院收治的良性甲状腺结节病人136例,随机数字表法分为MWA组和手术组各68例。比较两组病人基线资料及手术时间、住院时间、住院费用、术后并发症情况,并比较两组术前1 d、术后6 h、24 h和72 h的超敏C反应蛋白(hs-CRP)、白细胞介素8(IL-8)、血清肿瘤坏死因子(TNF-α)、静止时疼痛视觉模拟评分(VAS)水平；所有病人术后1个月、3个月和6个月行常规超声和甲状腺功能检查,观察结节和甲状腺激素水平的变化。结果 两组病人基线资料之间均差异无统计学意义(均P>0.05),手术组与MWA组相比,手术时间长,住院时间长,费用高,术后颈部不适、发热病人比率高(均P<0.05)；术后6 h、24 h和72 h手术组体温、IL-8、hs-CRP、TNF-α、VAS水平均高于MWA组(均P<0.05)；两组病人术后3、6个月随访,甲状腺结节均未复发,而手术组病人游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)水平低于MWA组(P<0.05),促甲状腺激素(TSH)水平高于MWA组(P<0.05),患甲状腺功能减退症比率高于MWA组。结论 微波消融术治疗甲状腺良性结节病人安全有效,对机体应激反应的影响明显小于外科手术切除治疗,并保留了甲状腺的生理功能,具有优越性和较高的临床价值。 |
| 英文摘要: |
| Object To compare the effect and safety of microwave ablation (MWA) and surgical resection in the treatment of thyroid benign nodules (BTN) under ultrasonic guidance and its effect on stress response.Methods A total of 136 patients with benign thyroid nodules admitted in our hospital from February 20 to January 2017 were randomly divided into MWA group and operation group with 68 cases in each group.The baseline data,the time of operation,the hospitalization time,the hospitalization cost and the postoperative complications were compared.Hs-CRP at 6 h,24 h and 72 h after operation were compared between the two groups.The patients were divided into two groups according to Interleukin-8 (IL-8),serum tumor necrosis factor(TNF-α) and hydrostatic visual analogue scale (VAS) at 1,3 and 6 months after operation.Thyroid function tests to observe changes in nodular and thyroid hormone levels.Results There were no significant differences in baseline data between the two groups (P>0.05).The operation group was longer than Compared with the MWA group,the operation time,the length of hospital stay,the cost and the postoperative complications were not with advantage (P<0.05).The levels of body temperature,IL-8,hs-CRP,TNF-α and VAS in the operation group were higher than those in the MWA group at 6 h,24 h and 72h after operation.The difference was statistically significant (P<0.05).There was no recurrence of thyroid nodules at 3 months and 6 months after operation.The patients in the operation group had lower level of free thyroxine (FT4),free triiodothyronine (P<0.05) and higher level of thyroid stimulating hormone (TSH) than that of MWA group (P<0.05).The rate of hypothyroidism was higher than that of MWA group (P<0.05).Conclusion Microwave ablation is a safe and effective treatment for patients with benign thyroid nodules.The stress response of microwave ablation is less than that of surgical resection,and the physiological function of thyroid is preserved,which has superiority and high clinical value. |
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