彩超引导下微波消融术治疗甲状腺肿瘤的疗效及对患者生活质量的影响
|
摘要
目的研究彩超引导下微波消融治疗术对甲状腺肿瘤的治疗效果及对患者生活质量的影响。方法选择2016年3月至2017年3月在东部战区总医院(原八一医院)就诊的甲状腺肿瘤患者100例,按不同手术方法随机分为常规组和微波组,每组50例。常规组患者采用手术治疗,微波组采用微波消融术治疗。采用高效液相色谱法对比分析所测的游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)、促甲状腺激素(TSH)水平,根据疼痛视觉模拟量表(VAS)评分、颈部CT检查肿瘤容积检查,分析对患者生活质量的影响,统计患者总有效率和并发症发生情况。结果微波组治疗后3个月、6个月FT_3、FT_4、TSH水平均高于常规组治疗后(P<0.05),患者VAS评分均低于常规组治疗后(P<0.05),患者躯体功能、情绪功能、社会功能评分均显著高于常规组治疗后(P<0.05),微波组总有效率显著高于常规组(94.00%vs 80.00%,P<0.01),并发症发生率显著低于常规组(6.00%vs 20.00%,P<0.01)。结论彩超引导下微波消融术对甲状腺肿瘤的治疗效果显著,并发症少,可以显著提高患者生活质量。
Objective To study the effect of microwave therapy guided by color doppler ultrasound on thyroid tumor and its effect on patients' quality of life.Methods 100 patients with thyroid tumors were selected from March 2016 to March 2017 in the 81st Hospital of PLA affiliated to Nanjing University of Traditional Chinese Medicine.The patients in the conventional treatment group were treated with surgery(suggesting that "routine"should be replaced by surgery),and those in the microwave treatment group were treated with microwave ablation.High performance liquid chromatography(HPLC)method is used to contrast analysis of measured three free iodine thyroid original glycine(FT3)and free thyroxine(FT4),thyroid stimulating hormone(TSH)levels,according to the pain visual analog scale(VAS)score,neck tumor volume CT examination examination,analysis influence on patients quality of life,the total effective rate and complications in patients with statistics.Results FT3,FT4 and TSH in the microwave treatment group were higher than those in the conventional treatment group at 3 and 6 months(P<0.05). The VAS score at 3 months and 6 months after treatment was lower than those in the conventional treatment group at 3 months and 6 months(P<0.05). The physical function,emotional function,social function score,physical function,emotional function and social function score in the microwave treatment group were significantly higher than those in the conventional treatment group(P<0.05). The total efficiency of microwave treatment group was significantly higher than that of conventional treatment group(94.00% vs 80.00%,P<0.01).The incidence of complications in microwave treatment group was significantly lower than that in the conventional treatment group(6.00% vs 20.00%,P<0.01).Conclusion Microwave ablation guided by color Doppler ultrasound is effective in the treatment of thyroid tumors with fewer complications,which can significantly improve the quality of life of patients.
Objective To study the effect of microwave therapy guided by color doppler ultrasound on thyroid tumor and its effect on patients' quality of life.Methods 100 patients with thyroid tumors were selected from March 2016 to March 2017 in the 81st Hospital of PLA affiliated to Nanjing University of Traditional Chinese Medicine.The patients in the conventional treatment group were treated with surgery(suggesting that "routine"should be replaced by surgery),and those in the microwave treatment group were treated with microwave ablation.High performance liquid chromatography(HPLC)method is used to contrast analysis of measured three free iodine thyroid original glycine(FT3)and free thyroxine(FT4),thyroid stimulating hormone(TSH)levels,according to the pain visual analog scale(VAS)score,neck tumor volume CT examination examination,analysis influence on patients quality of life,the total effective rate and complications in patients with statistics.Results FT3,FT4 and TSH in the microwave treatment group were higher than those in the conventional treatment group at 3 and 6 months(P<0.05). The VAS score at 3 months and 6 months after treatment was lower than those in the conventional treatment group at 3 months and 6 months(P<0.05). The physical function,emotional function,social function score,physical function,emotional function and social function score in the microwave treatment group were significantly higher than those in the conventional treatment group(P<0.05). The total efficiency of microwave treatment group was significantly higher than that of conventional treatment group(94.00% vs 80.00%,P<0.01).The incidence of complications in microwave treatment group was significantly lower than that in the conventional treatment group(6.00% vs 20.00%,P<0.01).Conclusion Microwave ablation guided by color Doppler ultrasound is effective in the treatment of thyroid tumors with fewer complications,which can significantly improve the quality of life of patients.
引文
[1]张娟娟,王少华.精准医学理念指导下的分化型甲状腺癌诊治进展[J].医学研究生学报,2015,28(12):1322-1326.
[2]房居高.提高甲状腺肿瘤诊疗的精准化程度,改善患者生存质量[J].中国耳鼻咽喉头颈外科,2017,24(2):57-58.
[3]王龙琦,陈坚,刘绪舜,等.微波消融术与传统开放手术在良性甲状腺结节治疗中对机体创伤影响的比较[J].中国微创外科杂志,2016,16(3):236-240.
[4]林宗武,陈洁,马成权.系统评价体系探讨微波消融术治疗甲状腺良性结节的临床应用价值[J].安徽医药,2019,23(1):封2,33-36.
[5]张平,贺亮,王志宏,等.腔镜辅助甲状腺肿瘤微创手术150例临床分析[J].中国现代普通外科进展,2015,18(7):564-565,571.
[6]闫文杰.甲状腺肿瘤普外科微创手术治疗的临床观察[J].湖南师范大学学报(医学版),2015,12(4):77-79.
[7]张春梅.甲状腺腺叶切除术治疗甲状腺结节的临床分析[J].中国继续医学教育,2015,7(23):89-90.
[8]张圣林,刁其先,王野,等.单侧腺叶切除术后甲状腺功能变化的研究[J].中国现代普通外科进展,2017,20(5):400-403.
[9]戴兴能.甲状腺良性结节患者单侧腺叶切除术后血清甲状腺激素的变化及其临床意义[J].特别健康,2018(14):8.
[10]高峰,吴迟.传统甲状腺切除术与改良小切口甲状腺切除术治疗甲状腺结节的临床疗效比较[J].标记免疫分析与临床,2016,23(5):514-516,561.
[11]马瑞斌,柯颖,张志刚,等.小切口改良甲状腺切除术与传统甲状腺切除术的比较研究[J].中国现代医生,2015,53(1):132-134.
[12]周克聚,刘静,高小虎,等.腔镜甲状腺切除术与开放甲状腺切除术治疗良性甲状腺疾病疗效比较[J].新乡医学院学报,2018,35(6):502-504,508.
[13] Gockner TL,Zelzer S,Mokry T,et al.Sphere-enhanced microwave ablation(sMWA)versus bland microwave ablation(bMWA):technical parameters,specific CT 3D rendering and histopathology[J]. Cardiovasc Intervent Radiol,2015,38(2):442-452.
[14] Li J,Liu Y,Liu J,et al.Ultrasound-guided percutaneous microwave ablation versus surgery for papillary thyroid microcarcinoma[J].Int J Hyperthermia,2018,34(5):653-659.
[15]吴菲,陈俊秀,郑舟琴,等.甲状腺功能正常的2型糖尿病患者甲状腺激素与血糖波动相关性分析[J].医学研究生学报,2018,31(12):1272-1275.
[16]周先利,赵欢,游婧怡,等.微波消融术治疗甲状腺良性结节疗效观察与并发症处理[J].局解手术学杂志,2017,26(11):826-830.
[17]葛善义.微波消融术治疗甲状腺良性肿瘤128例疗效分析[J].中国慢性病预防与控制,2016,24(8):618-619.
[18]萧林海.超声导向微波消融术与传统开放手术治疗甲状腺良性结节的临床效果比较[J].中国临床新医学,2018,11(2):180-183.
[19]莫伶丽,田福年,莫金霖,等.多模态超声引导下经皮微波消融术治疗甲状腺良性结节的疗效与安全性分析[J].广西医科大学学报,2017,34(1):86-90.
[20]杨雪丰,陈建发,冯蕊,等.超声引导下经皮微波消融术治疗甲状腺良性结节55例临床分析[J].广东医学院学报,2016,34(2):169-172.
[2]房居高.提高甲状腺肿瘤诊疗的精准化程度,改善患者生存质量[J].中国耳鼻咽喉头颈外科,2017,24(2):57-58.
[3]王龙琦,陈坚,刘绪舜,等.微波消融术与传统开放手术在良性甲状腺结节治疗中对机体创伤影响的比较[J].中国微创外科杂志,2016,16(3):236-240.
[4]林宗武,陈洁,马成权.系统评价体系探讨微波消融术治疗甲状腺良性结节的临床应用价值[J].安徽医药,2019,23(1):封2,33-36.
[5]张平,贺亮,王志宏,等.腔镜辅助甲状腺肿瘤微创手术150例临床分析[J].中国现代普通外科进展,2015,18(7):564-565,571.
[6]闫文杰.甲状腺肿瘤普外科微创手术治疗的临床观察[J].湖南师范大学学报(医学版),2015,12(4):77-79.
[7]张春梅.甲状腺腺叶切除术治疗甲状腺结节的临床分析[J].中国继续医学教育,2015,7(23):89-90.
[8]张圣林,刁其先,王野,等.单侧腺叶切除术后甲状腺功能变化的研究[J].中国现代普通外科进展,2017,20(5):400-403.
[9]戴兴能.甲状腺良性结节患者单侧腺叶切除术后血清甲状腺激素的变化及其临床意义[J].特别健康,2018(14):8.
[10]高峰,吴迟.传统甲状腺切除术与改良小切口甲状腺切除术治疗甲状腺结节的临床疗效比较[J].标记免疫分析与临床,2016,23(5):514-516,561.
[11]马瑞斌,柯颖,张志刚,等.小切口改良甲状腺切除术与传统甲状腺切除术的比较研究[J].中国现代医生,2015,53(1):132-134.
[12]周克聚,刘静,高小虎,等.腔镜甲状腺切除术与开放甲状腺切除术治疗良性甲状腺疾病疗效比较[J].新乡医学院学报,2018,35(6):502-504,508.
[13] Gockner TL,Zelzer S,Mokry T,et al.Sphere-enhanced microwave ablation(sMWA)versus bland microwave ablation(bMWA):technical parameters,specific CT 3D rendering and histopathology[J]. Cardiovasc Intervent Radiol,2015,38(2):442-452.
[14] Li J,Liu Y,Liu J,et al.Ultrasound-guided percutaneous microwave ablation versus surgery for papillary thyroid microcarcinoma[J].Int J Hyperthermia,2018,34(5):653-659.
[15]吴菲,陈俊秀,郑舟琴,等.甲状腺功能正常的2型糖尿病患者甲状腺激素与血糖波动相关性分析[J].医学研究生学报,2018,31(12):1272-1275.
[16]周先利,赵欢,游婧怡,等.微波消融术治疗甲状腺良性结节疗效观察与并发症处理[J].局解手术学杂志,2017,26(11):826-830.
[17]葛善义.微波消融术治疗甲状腺良性肿瘤128例疗效分析[J].中国慢性病预防与控制,2016,24(8):618-619.
[18]萧林海.超声导向微波消融术与传统开放手术治疗甲状腺良性结节的临床效果比较[J].中国临床新医学,2018,11(2):180-183.
[19]莫伶丽,田福年,莫金霖,等.多模态超声引导下经皮微波消融术治疗甲状腺良性结节的疗效与安全性分析[J].广西医科大学学报,2017,34(1):86-90.
[20]杨雪丰,陈建发,冯蕊,等.超声引导下经皮微波消融术治疗甲状腺良性结节55例临床分析[J].广东医学院学报,2016,34(2):169-172.