摘要
目的观察超声下微波消融(MWA)术治疗甲状腺微小癌(TMC)效果及对血清甲状腺激素影响。方法纳入TMC患者100例,随机分为观察组、对照组各50例,对照组行传统甲状腺切除术,观察组行超声下MWA术,比较两组手术情况、血清甲状腺激素[促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)]水平、并发症发生率、生活质量[简明健康量表(SF-36)]及复发率。结果观察组手术时间、切口长度、术中出血量、住院时间皆显著低于对照组(P <0.05);术后1个月,观察组TSH显著低于对照组(P <0.05),FT3、FT4显著高于对照组(P <0.05);观察组术后并发症总发生率8.00%,显著低于对照组的26.00%(P <0.05);术后3个月,两组SF-36评分皆显著高于术前(P <0.05),且观察组升幅大于对照组(P <0.05);两组6个月内复发率比较无显著差异(P> 0.05)。结论超声下MWA术治疗TMC的创伤小,对甲状腺功能影响小、并发症少,可提高生活质量,且不增加复发率。
Objective To observe the effect of ultrasound-guided microwave ablation (MWA) on thyroid microcarcinoma (TMC) and that on serum thyroid hormones. Methods A total of 100 patients with TMC were randomly divided into an observation group and a control group (n =50, respectively). The control group underwent conventional thyroidectomy and the observation group underwent ultrasound-guided MWA. The levels of serum thyroid hormones [thyroid stimulating hormone (TSH), free three-iodine thyronine (FT3) and free thyroxine (FT4)], the incidence of complications, the quality of life (Short Form 36 Health Survey, SF36) and the recurrence rate were compared between the two groups. Results The operation time, incision length, intraoperative bleeding volume and hospitalization time in the observation group were significantly lower than those in the control group(P < 0.05);one month after the operation, TSH in the observation group was significantly lower than that in the control group (P < 0.05), and FT3 and FT4 were significantly higher than those in the control group (P < 0.05);the total incidence of complications in the observation group was 8.00%, significantly lower than that (26.00%) in the control group (P < 0.05);three months after the operation, the SF-36 scores in both groups were significantly higher than those before the operation (P < 0.05) and the increase of the observation group was larger than that of the control group (P < 0.05);there was no difference in the recurrence rate between the two groups within six months(P > 0.05). Conclusion Ultrasound-guided MWA for TMC has less trauma, has less impacts on thyroid function and fewer complications, and can improve the quality of life without increasing the recurrence rate.
作者
霍齐民
周宁明
曹伟田
蒋俊杰
Huo Qimin;Zhou Ningming;Cao Weitian;Jiang Junjie(Department of Ultrasound,the Fifth People's Hospital of Shanghai,Shanghai,200240,China)
出处
《西南国防医药》
CAS
2019年第2期146-148,共3页
Medical Journal of National Defending Forces in Southwest China
关键词
甲状腺
微小癌
微波消融术
甲状腺激素
复发
生活质量
thyroid gland
microcarcinoma
microwave ablation
thyroid hormone
recurrence
quality of life
