摘要
目的 探讨超声引导下微波消融术治疗甲状腺乳头状微小癌的安全性及疗效。方法 回顾性选取190例甲状腺乳头状微小癌患者,随机分为微波消融组(n=95)和常规手术组(n=95)。比较2组的术中指标、术后疗效、术后甲状腺功能与炎症反应指标及随访结果。结果 微波消融组的手术时间显著短于常规手术组(P<0.001),术中出血量少于常规手术组(P<0.001)。微波消融组术后并发症发生率较低(P<0.05),住院时间[(2.5±0.8)天]和术后疼痛评分[VAS(2.1±0.7)]显著优于常规手术组(P<0.001),术后甲状腺功能(TSH、FT3、FT4)和炎症反应指标(CRP、白细胞计数)优于常规手术组(P<0.05)。2组1年随访的局部复发率和无病生存率无统计学差异(P>0.05)。结论 超声引导下微波消融术治疗甲状腺乳头状微小癌具有显著的短期疗效优势,术中创伤小,术后恢复快,并发症发生率低,且在长期肿瘤控制方面与常规手术相当,是一种安全、有效的微创治疗选择。
Objective To evaluate the safety and efficacy of ultrasound-guided microwave ablation(MWA)in the treatment of papillary thyroid microcarcinoma.Methods A total of 190 patients with papillary thyroid microcarcinoma were retrospectively selected and randomized into microwave ablation group(n=95)and conventional surgery group(n=95).The intraoperative indicators,postoperative efficacy,postoperative thyroid function and inflammatory response indicators,follow-up results of the 2 groups were compared.Results The operation time in the microwave ablation group was significantly shorter than that in the conventional surgery group(P<0.001),and the intraoperative bleeding volume was less than that in the conventional surgery group(P<0.001).The microwave ablation group had a lower postoperative complication rate(P<0.05),hospital stay[(2.5±0.8)days]and postoperative pain score[VAS(2.1±0.7)]were significantly better than the conventional surgery group(P<0.001),and thyroid function(TSH,FT3,FT4)and inflammatory response index(CRP,WBC count)after surgery were better than the conventional surgery group(P<0.05).There was no statistical difference in local recurrence and disease-free survival at 1-year follow-up in the 2 groups(P>0.05).Conclusion Ultrasound-guided microwave ablation for papillary thyroid microcarcinoma has significant short-term efficacy advantages,small intraoperative trauma,fast postoperative recovery,low complication rate,and comparable to conventional surgery in long-term tumor control,which is a safe and effective minimally invasive treatment option.
作者
李龙鹤
陈媛媛
张箭
LI Longhe;CHEN Yuanyuan;ZHANG Jian(Zhoukou Central Hospital,Zhoukou,466000)
出处
《实用癌症杂志》
2025年第7期1122-1125,1129,共5页
The Practical Journal of Cancer
关键词
微波消融
超声引导
甲状腺乳头状微小癌
微创治疗
疗效
Microwave ablation
Ultrasound-guided
Papillary thyroid microcarcinoma
Minimally invasive treatment
Long-term outcomes
