摘要
目的探讨超声引导下微波消融在治疗甲状腺良性结节过程中产生的临床效果,并对不良预后的因素进行分析。方法回顾性分析2020年1月至2020年12月在空军军医大学第一附属医院核医学科进行甲状腺良性结节微波消融术后随访的患者93例,对比治疗前后超声下结节体积和甲状腺相关激素水平。以治疗后6个月的体积缩小率(VRR)为分组依据将患者分为疗效良好组(VRR≥50%,67例)和疗效欠佳组(VRR<50%,26例),分析引起疗效差异的原因。结果与治疗前相比,治疗后6个月结节体积明显缩小(P<0.001)。分别在治疗后24h、1个月、6个月对甲状腺相关激素水平进行随访,发现甲状腺过氧化物酶(anti-TPO)水平未出现明显波动(P=0.445);其余甲状腺相关激素水平均出现波动,差异具有统计学意义(P<0.001),但仍在正常参考范围内。在对疗效差异进行分析时发现,甲状腺结节性质是影响疗效,也是影响疗效的独立危险因素。结论微波消融术在治疗甲状腺良性结节时未对甲状腺功能造成明显影响,引起的自身免疫反应有限,具有良好的安全性。甲状腺结节性质是不良预后的独立危险因素。
Objective To investigate the efficacy of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules,and to identify the risk factors of prognosis.Methods 93 patients who were followed up after microwave ablation of benign thyroid nodules in the Department of Nuclear Medicine of the First Affiliated Hospital of Air Force Military Medical University from January,2020 to December,2020 were analyzed retrospectively.The nodules volume and thyroid related hormones before and after treatment were compared.Based on the volume reduction rate(VRR)of 6 months after treatment,these patients were divided into the good therapeutic effect group(VRR≥50%,67 cases)and the poor therapeutic effect group(VRR<50%,26 cases).Results Compared with the nodules volume before treatment,the volume decreased significantly within 6 months after treatment(P<0.001).There were significant differences in thyroid related hormone levels among 24 hours,1 month and 6 months after treatment(P<0.001),and there was no significant difference in thyroid peroxidase antibody(anti-TPO)during the treatment(P=0.445).When analyzing the differences in efficacy,it was found that the character of thyroid nodules was the independent risk factor for the efficacy of intervention.Conclusion Microwave ablation has no significant effect on thyroid function in the treatment of benign thyroid nodules,and the autoimmune response is limited,with a good safety.And the character of thyroid nodules is the independent risk factor for a poor prognosis.
作者
张明
康飞
汪静
周详
张皓
王喜青
ZHANG Ming;KANG Fei;WANG Jing;ZHOU Xiang;ZHANG Hao;WANG Xiqing(Department of Nuclear Medicine,the First Affiliated Hospital of Fourth Military Medical University,Xi’an 710032,China)
出处
《标记免疫分析与临床》
CAS
2022年第11期1881-1885,共5页
Labeled Immunoassays and Clinical Medicine
基金
国家自然科学基金(编号:81971646)。
关键词
甲状腺良性结节
微波消融
甲状腺功能
Benign thyroid nodule
Microwave ablation
Thyroid function
