摘要
目的系统评价超声引导下射频消融与外科手术治疗甲状腺微小乳头状癌(PTMC)的疗效和安全性。方法计算机检索PubMed、Cochrane图书馆、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献数据库公开发表的关于超声引导下射频消融及外科手术治疗PTMC的相关文献,检索时间为建库至2021年11月。由两名研究者严格按照纳入及排除标准独立进行文献筛选、资料提取并对纳入文献进行质量评价,采用Revman 5.4软件进行Meta分析。结果最终纳入8篇文献,共1932例PTMC患者,其中行超声引导下射频消融治疗患者972例(射频消融组),行外科手术治疗患者960例(外科手术组)。Meta分析结果显示:与外科手术组比较,射频消融组术后并发症少[风险比(RR)=0.28,95%可信区间:0.12~0.63,P=0.002]、手术时间短[均数差(MD)=-54.65,95%可信区间:-65.83~-43.46,P<0.05]、术中失血量少(MD=-25.15,95%可信区间:-29.10~-21.20,P<0.05)、术后住院时间短(MD=-2.48,95%可信区间:-3.00~-1.95,P<0.05)。两组术后复发或转移发生率相当[RR=1.14,95%可信区间(0.52~2.51),P=0.74]。结论超声引导下射频消融治疗PTMC较外科手术更具优势,具有较高临床应用价值。
Objective To systematically evaluate the effect and security of ultrasound-guided radiofrequency ablation and surgery in the treatment of papillary thyroid microcarcinoma(PTMC).Methods Relevant literatures on ultrasound-guided radiofrequency ablation and surgery treatment of PTMC published from the establishment of the database to November 2021 were searched in databases including PubMed,Cochrane Library,Embase,Web of Science,CNKI,Wan Fang,VIP and SinoMed.Two researchers independently screened literature,extracted data in strict accordance with the inclusion and exclusion criteria and evaluated the quality of the included literatures.Revman 5.4 software was used for meta-analysis.Results A total of 8 articles,involving 1932 patients were included,in which 972 cases were treated with radiofrequency ablation(radiofrequency ablation group)and 960 cases were treated with surgery(surgery group).Meta-analysis results showed that:compared with the surgery group,the radiofrequency ablation group had fewer postoperative complications(RR=0.28,95%CI:0.12~0.63,P=0.002),less operation time(MD=-54.65,95%CI:-65.83~-43.46,P<0.05),less intraoperative blood loss(MD=-25.15,95%CI:-29.10~-21.20,P<0.05),shorter postoperative hospital stay(MD=-2.48,95%CI:-3.00~-1.95,P<0.05).The incidence of postoperative recurrence or metastasis was similar between the two groups(RR=1.14,95%CI:0.52~2.51,P=0.74).Conclusion Ultrasoundguided radiofrequency ablation has more advantages than surgery in the treatment of PTMC,which has high clinical application value.
作者
易福周
李爱玲
贾娟
刘慧
YI Fuzhou;LI Ailing;JIA Juan;LIU Hui(Southwest Medical University,Sichuan 646000,China)
出处
《临床超声医学杂志》
CSCD
2022年第10期766-771,共6页
Journal of Clinical Ultrasound in Medicine
关键词
超声引导
射频消融
外科手术
甲状腺微小乳头状癌
系统评价
Ultrasound-guided
Radiofrequency ablation
Surgery
Thyroid papillary microcarcinoma
Systematic review
