| 林宗武,陈洁,马成权.系统评价体系探讨微波消融术治疗甲状腺良性结节的临床应用价值[J].安徽医药,2019,23(1):33-36. |
| 系统评价体系探讨微波消融术治疗甲状腺良性结节的临床应用价值 |
| Clinical values of microwave ablation in the treatment of benign thyroid nodules |
| 投稿时间：2017-08-23 |
| DOI： |
| 中文关键词: 甲状腺结节 微波 导管消融术 超声检查 治疗结果 |
| 英文关键词: Thyroid nodules Microwaves Catheter ablation Ultrasonography Treatment outcome |
| 基金项目: |
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| 中文摘要: |
| 目的 运用系统评价体系探讨微波消融术治疗甲状腺良性结节的临床应用价值。方法 回顾性分析2015年5月至2016年2月期间入住皖北煤电集团总医院并行超声引导下微波消融术治疗甲状腺良性结节的50例病人的资料。术后随访6个月,运用系统评价系统从症状(术中)、术后并发症、实验室检测及彩超检查等多方面评估其治疗效果及术后并发症发生情况,进一步客观、全面明确其临床价值。结果 所有病人术中不适主诉发生率低,且均可耐受；术后颈部无疤痕；术后并发症少,1周后均明显恢复,未出现永久性后遗症。与术前甲状腺功能相比,术后3 d游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)明显升高,促甲状腺激素(TSH)明显下降,差异有统计学意义；术后1个月FT3、FT4及TSH均与术前相仿,差异无统计学意义。与术前炎症因子相比,术后第一天C反应蛋白(CRP)、肿瘤坏死因子-α (TNF-α)、白介素-6(IL-6)差异有统计学意义；术后1周,其炎症因子水平均差异无统计学意义。治疗前直径(2.58±0.50) cm,结节体积(3.50±0.51) cm3；随访6个月后病人的结节直径(0.65±0.33) cm,结节体积(0.37±0.46) cm3,治疗前后差异有统计学意义(P<0.05)。病人治疗6月后总有效率达90%,痊愈10%,有效80%,好转10%,失败0%。结论 系统评价体系评估超声引导微波消融术治疗甲状腺结节具有创伤小、无疤痕、术后恢复快等优点,具有一定的临床推广意义。 |
| 英文摘要: |
| Objective Using the systematic evaluation system to investigate the clinical values of microwave ablation in the treatment of benign thyroid nodules.Methods We retrospective analyzed the clinical data of 50 patients with benign thyroid nodules treated by microwave ablation under the guidance of ultrasound in the Thyroid and Breast Center of our hospital from May-2015 to February-2016.After 6 months' follow-up,evaluation system assessed the therapeutic effection and postoperative complications from the symptoms (intraoperative),postoperative complications,laboratory detections and ultrasound examination,further objectively and comprehensively clarify its clinical values.Results There were low rate of discomfort incidence in all patients,that can be tolerated,with no neck scar.Postoperative complication is low.All patients recoveried in a week.No permanent sequel was found.Compared with the preoperative thyroid function,FT3 and FT4 increased significantly after 3 days,and the TSH decreased significantly.The difference was statistically significant.The FT3,FT4 and TSH were similar to those before surgery,and the difference was not statistically significant.Compared with the preoperative inflammatory factors,there was a statistically significant difference in CRP,IL-6 and TNF-a of the first day postoperative.There was no statistically significant in those factors1 week later.The average diameter of all nodules before treatment is about (2.58±0.50) cm,nodule volume (3.50±0.51) cm3.After 6 months' follow-up,the average diameter of nodules is about (0.65±0.33) cm,nodule volume (0.37±0.46) cm3.There were statistically significant differences (P<0.05).After 6 months,the total effective rate was 90%,and the cured rate,effective rate were 10%was and 80% respectively.10% were improved and 0% failed.Conclusion Evaluating by systematic evaluation system,ultrasound guided microwave ablation for the treatment of thyroid nodules has the advantages of less trauma,no scar,faster postoperative recovery,with certain clinical significances. |
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