微波消融术与经颈部侧切口手术治疗老年患者单侧良性甲状腺结节的疗效分析

Effect Comparison between Microwave Ablation and Thyroid Removal via Lateral Cervical Surgery for Benign Thyroid Nodules in Old Patients

摘要: 目的：研究老年患者中采用微波消融术与经颈部侧切口单侧甲状腺切除术治疗良性甲状腺结节疾病的临床疗效。方法：顺序入组广东省韶关市粤北人民医院于2017年1月至2019年12月经超声引导细针穿刺活检确诊为良性单侧甲状腺结节患者120例，所有患者的年龄 ≥ 60岁，其中采用微波消融术治疗60例作为消融组，60例采用经颈部侧切口甲状腺切除术作为对照组，观察对比两组的治疗效果。结果：消融组手术时长、术中出血量、住院总时长、术后并发症发生率，均明显小于开放手术组(P < 0.05)；与开放甲状腺切除术相比，微波消融治疗甲状腺结节能够明显降低术后疼痛感以及提升美容评价(P < 0.05)，同时能够更好避免对患者甲状腺功能的影响(P < 0.05)；随访测量消融组甲状腺结节术后12个月内变化情况，显示术后12个月甲状腺结节平均体积缩小率达90.7%，具有明显的治疗效果。结论：微波消融治疗老年甲状腺结节患者具有微创、创伤小、安全性高等优点，能够明显降低患者麻醉风险、术后疼痛感以及提升美容评价，同时能避免影响患者的甲状腺功能，值得临床推广应用。

Abstract: Objective: To study the therapeutic effect of microwave ablation and Thyroid removal via lateral cervical surgery in the treatment of benign thyroid nodular disease in old patients. Methods: 120 patients who were diagnosed as benign unilateral thyroid nodule and treated in our hospital from Jan. 2017 and Dec. 2019 were randomly divided into Thyroid removal via lateral cervical surgery group and microwave ablation group, aged 60 or above. The thyroid removal via lateral cervical surgery group (60 cases) was treated with thyroid removal via lateral cervical surgery and the microwave ablation group (60 cases) was treated with microwave ablation, and then compared the Ecacy. Results: The operation time and the length of hospital stay of the microwave ablation group are lower than that of the therapy of the thyroid removal via lateral cervical surgery group, with lower blood loss and incidence of postoperative complications (P < 0.05). Compared with the Thyroid removal via lateral cervical surgery group, microwave ablation has less postoperative pain and less effect of thyroid function, with higher cosmetic score (P < 0.05). Finally, after 12 months of regular follow-up of microwave ablation group, the shrinking rate of the volume of thyroid nodule is up to 90.7%, showing obvious therapeutic effect. Conclusions: Microwave ablation for the treatment of patients with old patients has the advantages of minimally invasive, less invasive, and high safety. It can significantly reduce postoperative pain and improve cosmetic evaluation, and can avoid affecting the thyroid function of patients. It is worthy of clinical application.