摘要
目的观察经皮微波消融治疗低风险甲状腺微小乳头状癌(PTMC)的效果和对患者生活质量的影响。方法对75例经病理证实的单发低风险(T1N0M0)PTMC患者行超声引导下经皮微波消融治疗。术后随访,分别于1、3、6、12、24个月观察治疗效果及并发症,并行躯体健康总评(PCS)、心理健康总评(MCS)和36项健康调查简表(SF-36)评分。结果75例均顺利完成手术。消融过程中4例出现短暂声嘶,2 h内恢复;15例自觉放射性耳根痛、颈部疼痛等,消融后立即缓解。术后24个月时治疗有效率100%(75/75),病灶消失率93.33%(70/75),无局部复发病例。术后1、3个月病灶最大径和体积均较术前增加,术后6、12、24个月病灶均较术前缩小(P均<0.05)。术前及术后各时间点促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平差异均无统计学意义(P均>0.05)。术前及术后不同时间点PCS得分差异无统计学意义(P>0.05),术后各时间点MCS得分及SF-36总分均高于术前(P均<0.05)。结论经皮消融治疗低风险PTMC安全、有效,并可提升患者生活质量。
Objective To observe the efficacy of percutaneous microwave ablation on low-risk papillary thyroid microcarcinoma(PTMC)and impact on patient's life quality.Methods Totally 75 pathologically confirmed patients with single low risk PTMC(T1N0M0)were treated with ultrasound-guided percutaneous microwave ablation and followed up at 1,3,6,12 and 24 months respectively after operation.The therapeutic effect and complications were observed,and score the physical component summary(PCS),mental component summary(MCS)and 36-item short form health survey(SF-36)scores were counted.Results The operation was successfully completed in all 75 patients.Four patients experienced temporary hoarseness during the ablation process and recovered within 2 h,while 15 patients complained of radiation-induced ear root pain,neck pain and other symptoms which immediately relieved after ablation.Twenty-four months after operation,the effective rate of treatment was 100%(75/75),the lesion disappearance rate was 93.33%(70/75),while no local recurrence occurred.The maximum diameter and volume of lesions increased 1 and 3 months after operation but decreased 6,12 and 24 months after operation(all P<0.05).There was no significant difference of thyroid stimulating hormone(TSH),free triiodothyronine(FT3)nor free thyroxine(FT4)levels among all time points(all P>0.05).PCS scores at different time points before and after operation showed no statistical significant difference(all P>0.05).MCS scores and SF-36 scores of all time points after operation were higher than those before operation(all P<0.05).Conclusion Percutaneous ablation is safe and effective for treating low risk PTMC,which can improve the patient's life quality.
作者
陈吉东
岳林先
熊晏群
顾毅
张惠
吴昊
贺伟
CHEN Jidong;YUE Linxian;XIONG Yanqun;GU Yi;ZHANG Hui;WU Hao;HE Wei(Ultrasound Medical Center,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China;Surgical Anesthesia Center,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China;Vascular Thyroid Surgery,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China)
出处
《中国介入影像与治疗学》
北大核心
2020年第10期577-580,共4页
Chinese Journal of Interventional Imaging and Therapy
基金
四川省科技厅重点研发项目(2020YFS0406)。
关键词
甲状腺癌
乳头状
超声检查
介入性
微波消融
生活质量
thyroid cancer,papillary
ultrasonography,interventional
microwave ablation
quality of life
