摘要
目的比较超声引导下射频消融(RFA)治疗与全腔镜下甲状腺根治术治疗甲状腺微小乳头状癌(PTMC)的临床效果。方法选取60例PTMC患者,随机分为消融组和腔镜组,各30例。其中腔镜组(全腔镜下甲状腺根治术),消融组(超声引导下RFA)。比较2组手术的相关指标(住院时间、术中出血量、手术时间及术后疼痛程度),甲状腺激素水平[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)],炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]及并发症发生情况。结果消融组住院时间、术中出血量、手术时间及术后疼痛程度明显低于腔镜组(P<0.05);消融组手术前后血清FT3、FT4、TSH水平比较无明显差异(P>0.05)。与术前比较,腔镜组术后血清FT3、FT4水平均明显降低(P<0.05),且腔镜组明显低于消融组(P<0.05);腔镜组术后血清TSH水平明显升高(P<0.05),且腔镜组明显高于消融组(P<0.05)。与术前比较,2组术后血清TNF-α、IL-6、CRP水平均明显降低(P<0.05),但消融组明显低于腔镜组(P<0.05)。2组并发症发生率比较无明显差异(P>0.05)。结论与全腔镜下甲状腺根治术相比,超声引导下RFA治疗PTMC能够更加有效地降低炎症反应,促进恢复,减少术中出血量,保留甲状腺功能,创伤更小,安全有效。
Objective To compare the clinical effects of ultrasound-guided radiofrequency ablation(RFA)and total laparoscopic radical thyroidectomy in treating papillary thyroid microcarcinoma(PTMC).Methods 60 PTMC patients were randomly grouped into a laparoscopy group(30 cases)and an ablation group(30 cases).The endoscopy group was given total laparoscopic radical thyroidectomy,and the ablation group was given ultrasound-guided RFA.The operation-related indicators(hospitalization time,intraoperative blood loss,operation time and postoperative pain degree),thyroid hormone levels(free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)],inflammatory factors[tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6)]and complications were compared.Results The hospital stay,intraoperative blood loss,operation time and postoperative pain degree in the ablation group were obviously lower than those in the endoscopic group(P<0.05);there was no obvious difference in serum FT3,FT4 and TSH levels in the ablation group before and after surgery(P>0.05).Compared with before operation,the postoperative serum FT3 and FT4 levels in the endoscopic group were obviously lower(P<0.05),and the endoscopic group were obviously lower than the ablation group(P<0.05);the postoperative serum TSH level in the endoscopic group was obviously increased(P<0.05),and the endoscopic group was obviously higher than that in the ablation group(P<0.05).Compared with before operation,postoperative serum TNF-α,IL-6,and CRP levels in both groups were obviously decreased(P<0.05),but the ablation group were obviously lower than the endoscopic group(P<0.05).There was no significant difference in the incidence of complications between the 2 groups(P>0.05).Conclusion Compared with total lapa-roscopic radical thyroidectomy,ultrasound-guided RFA in the treatment of PTMC can more effectively reduce the inflammatory response,promote recovery,reduce intraoperative blood loss,preserve thyroid function,and be safe and effective with less trauma.
作者
王熠辰
苏自杰
丁超
孙文聪
WANG Yichen;SU Zijie;DING Chao(Henan People's Hospital,Zhengzhou,450052)
出处
《实用癌症杂志》
2024年第6期929-932,共4页
The Practical Journal of Cancer
基金
2021年度河南省医学科技攻关计划联合共建项目立项目录(编号:LHGJ20210053)。
关键词
甲状腺微小乳头状癌
全腔镜下甲状腺根治术
超声引导下射频消融
临床效果
Papillary thyroid microcarcinoma
Total endoscopic radical thyroidectomy
Ultrasound-guided radiofrequency ablation
Clinical effect
