老年甲状腺良性结节微波消融疗效观察及安全性评价

doi:10.3969/j.issn.1003-9198.2024.03.009

摘要/Abstract

摘要： 目的探讨超声引导下经皮微波消融术(MWA)治疗不同成分老年甲状腺良性结节的疗效及安全性。方法回顾性纳入2015年1月至2018年3月行超声引导下甲状腺结节MWA治疗的老年病人共69例,按结节类型分为囊性、实性和混合性3组。所有病人在治疗前及治疗后第1、3、6、12个月时进行随访,观察结节体积缩减率以及甲状腺功能等指标的变化。结果术后12个月,有7例(10.1%)病人表现为亚临床甲减,1例病人(1.4%)出现亚临床甲亢。3组病人血清甲状腺球蛋白水平较治疗前均显著下降(P<0.01),血清抗甲状腺球蛋白抗体(TgAb)、抗甲状腺过氧化物酶抗体(TPOAb)水平在术后均无明显改变(P>0.05)。囊性结节在随访第12个月时体积缩减率为92.91%,明显高于实性结节(72.55%)和混合性结节(89.45%)。结论超声引导下经皮MWA是治疗老年甲状腺良性结节病人的安全、有效方法,能显著缩小结节体积,对病人甲状腺功能影响轻微。

关键词: 老年人, 甲状腺结节, 微波消融术, 甲状腺功能

Abstract: Objective To investigate the effect of ultrasound-guided percutaneous microwave ablation(MWA) on benign thyroid nodules with different components, and to analyze the effects on thyroid function in the elderly patients. Methods A total of 69 elderly patients (48 females, 21 males, 60-82 years old) with thyroid nodules who received ultrasound-guided MWA in Jiangsu Procince Geriatric Hospital and the First Affiliated Hospital of Nanjing Medical University from January 2015 to March 2018 were retrospectively enrolled. According to the main ablation nodules, the patients were divided into cystic nodules group, solid nodules group and mixed nodules group. All patients were followed up for 1, 3, 6 and 12 months after treatment.The changes of nodule volume reduction rate and thyroid function were detected. Results Twelve months after treatment, 7 patients (10.1%) presented with subclinical hypothyroidism, and 1 patient (1.4%) presented with subclinical hyperthyroidism. The serum level of thyroglobulin in all groups was significantly lower than that before treatment (P<0.01), and the serum levels of antithyroglobulin antibody (TgAb) and anti-thyroid peroxidase antibody(TPOAb) did not change significantly after MWA (P>0.05). At the 12th month of follow-up, the volume reduction rate in cystic nodule patients was 92.91%, compared with 72.55% in solid nodules group and 89.45%in mixed nodules group(P<0.05). Conclusions Ultrasound-guided percutaneous MWA is a safe and effective method for the treatment of benign thyroid nodules in the elderly patients. It can significantly reduce the volume of thyroid nodules and has slight influence on thyroid function.

Key words: aged, thyroid nodule, microwave ablation, thyroid function

中图分类号:

R 581.3

胡翠宁, 唐伟, 吴丹, 徐婷, 范伯强. 老年甲状腺良性结节微波消融疗效观察及安全性评价[J]. 实用老年医学, 2024, 38(3): 251-254.

HU Cuining, TANG Wei, WU Dan, XU Ting, FAN Boqiang. Evaluation of efficacy and safety of microwave ablation in treatment of benign thyroid nodules in elderly patients[J]. Practical Geriatrics, 2024, 38(3): 251-254.

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