摘要
目的评价超声引导下经皮微波消融治疗与外科手术切除治疗甲状腺微小乳头状癌患者的安全性和价值。方法选择医院在2020年4月—2021年4月期间接诊的82例甲状腺微小乳头状癌患者,利用随机数表法分组,对照组与观察组各41例,对照组给予外科手术切除治疗,观察组给予超声引导下经皮微波消融治疗,将两组治疗效果进行对比。结果观察组术后并发症发生率(4.88%)与对照组相比差异无统计学意义(χ^(2)=0.179,P=0.671)。观察组术中失血量(2.23±1.02)mL低于对照组,手术时间(25.11±8.51)min和住院时间(2.79±0.65)d短于对照组,差异有统计学意义(t=7.565、18.844、8.557,P<0.001)。术后观察组促甲状腺激素(TSH)(1.50±0.72)mIU/L低于对照组,游离甲状腺素(FT4)(4.33±0.65)pmol/L和游离三碘甲状腺素(FT3)(13.22±2.63)pmol/L高于对照组,差异有统计学意义(t=10.041、3.343、2.412,P<0.05)。观察组术前、术后4周、术后8周和术后24周的结节体积(62.36±6.52)、(78.91±5.51)、(32.46±4.52)、(11.65±3.52)mm^(3)与对照组相比差异无统计学意义(t=0.048、0.024、0.100、0.163,P>0.05)。结论甲状腺微小乳头状癌患者超声引导下经皮微波消融治疗与外科手术切除治疗均可以取得理想的效果,创伤更小,值得推广使用。
Objective To evaluate the safety and value of ultrasound-guided percutaneous microwave ablation and surgical resection for patients with papillary thyroid microcarcinoma.Methods A total of 82 patients with papillary thyroid microcarcinoma who were admitted by the hospital from April 2020 to April 2021 were selected and grouped by random number table method.There were 41 cases in the control group and the observation group,and the control group was given surgical resection.The observation group was given ultrasound-guided percutaneous microwave ablation,and the therapeutic effects of the two groups were compared.Results There was no statistically significant difference between the observation group and the control group in the incidence of postoperative complications(4.88%)(χ^(2)=0.179,P=0.671).The intraoperative blood loss in the observation group was(2.23±1.02)mL lower than that in the control group,and the operation time(25.11±8.51)min and hospital stay(2.79±0.65)d were shorter than those in the control group,the differences was statistically significant(t=7.565,18.844,8.557,P<0.001).postoperative,thyroid stimulating hormone(TSH)(1.50±0.72)mIU/L in the observation group was lower than that in the control group,free thyroxine(FT4)(4.33±0.65)pmol/L and free triiodothyronine(FT3)(13.22±2.63)pmol/L in the observation group was higher than that of the control group,and the difference was statistically significant(t=10.041,3.343,2.412,P<0.05).The nodule volume of observation group before operation,4 weeks after operation,8 weeks after operation and 24 weeks after operation were(62.36±6.52)mm^(3),(78.91±5.51)mm^(3),(32.46±4.52)mm_(3),(11.65±3.52)mm^(3) compared with the control group,there was no statistically significant difference(t=0.048,0.024,0.100,0.163,P>0.05).Conclusion Ultrasound-guided percutaneous microwave ablation and surgical resection can achieve ideal results in patients with papillary thyroid microcarcinoma with less trauma,which is worthy of popularization.
作者
张文杰
ZHANG Wenjie(Second Department of Surgery,Central Hospital of Mudan District,Heze,Shandong Province,274000 China)
出处
《世界复合医学》
2022年第2期146-149,共4页
World Journal of Complex Medicine
