摘要
目的探究四维B超引导定位穿刺结节性甲状腺肿微波消融术的应用效果。方法回顾性分析2015年5月至2016年4月南京市第二医院外三科和江苏省人民医院普通外科收治的84例结节性甲状腺肿患者的临床资料,分为观察组和对照组,每组各42例。对照组采用甲状腺常规开放切除术,观察组采用四维B超引导定位穿刺微波消融术。对比两组患者术中出血量、手术时间、手术治疗效果、术后并发症等指标。结果观察组患者术中出血量、手术时间、住院天数、术后颈部瘢痕大小分别为(2. 36±0. 52) ml、(36. 93±5. 59) min、(3. 62±0. 58) d、(0. 43±0. 08) cm,均分别低于对照组的(30. 37±2. 85) ml、(75. 64±6. 37) min、(11. 35±1. 27) d、(3. 25±0. 57) cm,两组比较差异均具有统计学意义(P <0. 05)。术后随访24个月,两组患者结节完全消融率分别为97. 6%、100%(P> 0. 05)。观察组患者术前以及术后3、6、12个月的结节体积分别为(2. 08±0. 42)、(1. 12±0. 38)、(0. 53±0. 12)、(0. 21±0. 04) cm3(P <0. 05),观察组术后3、6、12个月的结节体积缩小率分别为46. 15%、74. 52%、89. 90%。观察组术后并发症发生率为7. 1%,低于对照组的23. 8%(P <0. 05)。结论四维B超引导定位穿刺结节性甲状腺肿微波消融术治疗效果确切,在术中出血量、手术时间、术后疗效等方面更具优势,且手术并发症较少。
Objective To investigate the application of four-dimensional B-ultrasound-guided nodular goiter puncture and microwave ablation.Methods Clinical data were retrospectively analyzed for 84 nodular goiter patients admitted to the Second Hospital of Nanjing and General Hospital of Jiangsu Province from May 2015 to April 2016.Control group(n=42)underwent routine open thyroidectomy.Observation group(n=42)underwent microwave ablation guided by four-dimensional B-ultrasound.Indicators such as intraoperative blood loss,operation time,surgical outcome,postoperative complications were compared between the two groups.Results For observation group,the intraoperative blood loss,operation time,hospitalization days,and scar size[(2.36±0.52)ml,(36.93±5.59)min,(3.62±0.58)d,(0.43±0.08)cm]were lower than control group[(30.37±2.85)ml,(75.64±6.37)min,(11.35±1.27)d,(3.25±0.57)cm](P<0.05).After 24 mo follow-up,the complete ablation rate of nodules for the two groups was 97.6%and 100%,respectively(P>0.05).Nodule size of the observation group before and 3,6 and 12 mo after surgery were(2.08±0.42),(1.12±0.38),(0.53±0.12),(0.21±0.04)cm 3(P<0.05),nodule size reduction rate being 46.15%,74.52%and 89.90%postoperatively.The incidence of postoperative complications in observation group(7.1%)was lower than in control group(23.8%)(P<0.05).Conclusion Four-dimensional B-ultrasound-guided puncture and microwave ablation is effective in treating nodular goiter regarding blood loss,operation time,postoperative outcome and complications.
作者
钟琰
陆辉
施杲旸
ZHONG Yan;LU Hui;SHI Gao-yang(The Third Departments of Surgery,Nanjing Hospital of Nanjing University of Traditional Chinese Medicine(The Second Hospital of Nanjing),Nanjing Jiangsu 210003,China;Department of General Surgery,Jiangsu People's Hospital,Nanjing Jiangsu 210003,China)
出处
《临床和实验医学杂志》
2018年第24期2670-2673,共4页
Journal of Clinical and Experimental Medicine
基金
江苏省卫生厅资助基金项目(编号:201301357)
