超声引导下微波消融联合超声造影与传统术式治疗甲状腺微小乳头状癌的疗效评估

Evaluation of the Efficacy of Ultrasound-Guided Microwave Ablation Combined with Contrast-Enhanced Ultrasound versus Traditional Surgical Procedures for the Treatment of Papillary Thyroid Microcarcinoma

摘要: 本研究回顾性分析了115例甲状腺微小乳头状癌(PTMC)患者，比较超声引导下微波消融联合超声造影(消融组，52例)与传统手术(手术组，63例)的疗效。结果显示，消融组所有病灶均一次性完全消融，并在随访18个月内完全吸收，消融组与手术组在淋巴结转移和复发率方面无显著差异。然而，消融组在安全性及术后生活质量方面优势明显：并发症发生率显著更低，手术时间、住院时间更短，术后疼痛更轻，且无颈部瘢痕，无需引流。生活质量评估显示，消融组在声音、心理、疤痕等方面问题更少，术后甲状腺功能(TSH、FT3、FT4)也优于手术组。研究表明，微波消融治疗PTMC安全有效，兼具微创、恢复快、并发症少等优点，能更好保护甲状腺功能并提升患者生活质量，有望成为介于主动监测与手术切除之间的理想治疗选择。

Abstract: This study retrospectively analyzed 115 patients with papillary thyroid microcarcinoma (PTMC) and compared the efficacy of ultrasound-guided microwave ablation combined with contrast-enhanced ultrasound (ablation group, 52 cases) with that of traditional surgery (surgery group, 63 cases). The results showed that all lesions in the ablation group were completely ablated in a single session and fully absorbed within an 18-month follow-up period, with no significant differences in lymph node metastasis or recurrence rates between the ablation and surgery groups. However, the ablation group demonstrated significant advantages in safety and postoperative quality of life: the incidence of complications was significantly lower, the procedure time and hospital stay were shorter, postoperative pain was milder, and there were no neck scars or need for drainage. Quality of life assessments indicated that the ablation group had fewer issues related to voice, psychological well-being, and scarring, and postoperative thyroid function (TSH, FT3, FT4) was better than that of the surgery group. The study suggests that microwave ablation is a safe and effective treatment for PTMC, offering the advantages of being minimally invasive, having a faster recovery, and having fewer complications. It also better preserves thyroid function and improves patients’ quality of life, making it a promising treatment option between active surveillance and surgical resection.