摘要
目的探讨微波消融术治疗甲状腺良性结节对甲状腺激素水平及应激反应程度的影响。方法回顾性分析2017年1月至2018年12月于徐州医科大学附属淮安医院就诊的120例甲状腺良性结节患者的临床资料,根据手术方式不同分为试验组和对照组,每组60例。试验组给予超声引导下微波消融术治疗,对照组给予传统手术切除治疗。观察两组患者治疗后的临床疗效,治疗前后甲状腺激素[游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、总三碘甲腺原氨酸(TT3)、总甲状腺素(TT4)、促甲状腺激素(TSH)]及应激激素[去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(CORT)]水平。结果试验组总有效率高于对照组[95.0%(57/60)比75.0%(45/60)](P<0.05)。治疗后,两组患者FT3、FT4、TT3、TT4水平均降低,TSH水平均升高,但试验组上述指标改变小于对照组(P<0.05);治疗后两组患者血清NE、E、CORT水平均升高,但试验组治疗后血清水平明显低于对照组(P<0.05);两组各指标组间、时点间、组间和时点间交互作用比较差异有统计学意义(P<0.01)。结论与传统手术切除治疗相比,微波消融术治疗甲状腺良性结节具有良好的疗效,可有效控制甲状腺激素水平,避免过度的应激反应。
Objective To investigate and compare the effects of microwave ablation and surgical excision on thyroid hormone levels and stress response in benign thyroid nodules.Methods The clinical data of 120 patients with benign thyroid nodules in Huai’an Hospital Affiliated to Xuzhou Medical University from Jan.2017 to Dec.2018 were retrospectively analyzed and divided into a test group and a control group according to the surgery method,60 cases each.The test group was treated with ultrasound-guided microwave ablation,while the control group was treated with traditional surgical excision.The curative effect after treatment,thyroid hormone level[free triiodothyronine(FT3),free thyroxine(FT4),total triiodothyronine(TT3),total thyroxine(TT4)and thyroid stimulating hormone(TSH)]and stress response hormones[norepinephrine(NE),adrenaline(E)and cortisol(CORT)]of the two groups before and after treatment were observed.Results The total effective rate of the test group was higher than that of the control group[95.0%(57/60)vs 75.0%(45/60)](P<0.05).After treatment,the level of FT3,FT4,TT3,TT4 decreased and the level of TSH increased in both groups,but the changes of the above indexes in the test group were smaller than those in the control group(P<0.05).After treatment,the serum NE,E,CORT level in both groups increased,but the serum level in the test group was significantly lower than that in the control group(P<0.05).There were significant differences in different indexes between groups,time points,and interactions of groups and time points(P<0.01).Conclusion Compared with the traditional surgical resection,microwave ablation has a good effect on benign thyroid nodules,which can effectively control the level of thyroid hormone and avoid excessive stress reaction.
作者
刘芳芳
黄选东
宋勇罡
任泽强
LIU Fangfang;HUANG Xuandong;SONG Yonggang;REN Zeqiang(Department of Thyroid and Breast Surgery,Huai′an Hospital Affiliated to Xuzhou Medical University,Huai′an 223000,China;Department of General Surgery,Huai′an Hospital Affiliated to Xuzhou Medical University,Huai′an 223000,China)
出处
《医学综述》
2019年第21期4321-4324,4329,共5页
Medical Recapitulate
