超声引导下经皮激光消融在甲状腺良性结节治疗中的疗效评价
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摘要
目的评价超声引导下经皮激光消融(percutaneous laser ablation,PLA)在治疗甲状腺良性结节(benign thyroid nodules,BTNs)中的有效性。方法检索有关PLA治疗BTNs相关文献,2位评价员按纳入及排除标准独立筛选、提取、评价文献质量,用软件Stata12.0行Meta分析。结果共纳入研究13篇,Meta分析显示PLA治疗后1个月TSH、T4、Tg较术前无统计学差异,TSH:SMD 95%CI:-0.01(-0.21~0.20);T4:SMD 95%CI:0.01(-0.19~0.22);Tg:SMD 95%CI:0.01(-0.07~0.38)。3个月后TSH变化无统计学差异,SMD 95%CI:0.21(-0.03~0.45);术后1、3、6、12个月结节体积缩小有统计学差异,1个月SMD95%CI:-0.52(-1.00~-0.04);3个月SMD 95%CI:-0.73(-1.16~-0.29);6个月SMD 95%CI:-0.90(-1.23~-0.58);12个月SMD 95%CI:-1.23(-1.75~-0.71)。结论 PLA不影响甲状腺重要血清生物学指标,明显缩小结节体积,并发症少,可望在临床中推广应用。
Objective To evaluate the effectiveness of ultrasound-guided percutaneous laser ablation(PLA)in the treatment of benign thyroid nodules(BTNs).Methods A computer-assisted search of databases,The combination of terms used included PLA and BTNs.two independent reviewers assessed inclusion criteria and quality of the trials,and evaluated the included studies and executed statistical analysis by using software STATA 12.0.Results A total of 13 literatures were enrolled in the study.One month later:TSH:SMD 95% CI:-0.01(-0.21-0.20);T4:SMD 95% 0.01(-0.19-0.22);Tg:SMD 95%CI:0.01(-0.07-0.38).There was no significant difference between TSH,T4 and Tg before treatment in PLA.Three months later,TSH was no significant difference between the two groups,SMD 95% CI:0.21(-0.03-0.45).but there were statistically significant differences about nodule volume after one month,three months,six months and twelve months,one month,SMD 95% CI:-0.52(-1.00--0.04);three months,SMD 95% CI:-0.73(-1.16-0.29);six months,SMD 95% CI:-0.90(-1.23--0.58);twelve months,SMD 95% CI:-1.23(-1.75--0.71).Conclusions PLA does not affect serum thyroid important biological indicators,reduces the nodular volume significantly,less complications,it is expected to be widely used in clinical practice.
Objective To evaluate the effectiveness of ultrasound-guided percutaneous laser ablation(PLA)in the treatment of benign thyroid nodules(BTNs).Methods A computer-assisted search of databases,The combination of terms used included PLA and BTNs.two independent reviewers assessed inclusion criteria and quality of the trials,and evaluated the included studies and executed statistical analysis by using software STATA 12.0.Results A total of 13 literatures were enrolled in the study.One month later:TSH:SMD 95% CI:-0.01(-0.21-0.20);T4:SMD 95% 0.01(-0.19-0.22);Tg:SMD 95%CI:0.01(-0.07-0.38).There was no significant difference between TSH,T4 and Tg before treatment in PLA.Three months later,TSH was no significant difference between the two groups,SMD 95% CI:0.21(-0.03-0.45).but there were statistically significant differences about nodule volume after one month,three months,six months and twelve months,one month,SMD 95% CI:-0.52(-1.00--0.04);three months,SMD 95% CI:-0.73(-1.16-0.29);six months,SMD 95% CI:-0.90(-1.23--0.58);twelve months,SMD 95% CI:-1.23(-1.75--0.71).Conclusions PLA does not affect serum thyroid important biological indicators,reduces the nodular volume significantly,less complications,it is expected to be widely used in clinical practice.
引文
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[2]GA WELLS B S,D O′CONNELL J P,WELCH V.The Newcastle-Ottawa Scale for assessing the quality of nonrandomized studies[J],2014,18(06):727-734.
[3]VOGL T J,STRAUB R,ZANGOS S,et al.MR-guided laserinduced thermotherapy(LITT)of liver tumours:experimental and clinical data[J].International journal of hyperthermia,2004,20(7):713-724.
[4]MA S,ZHOU P,WU X,et al.Detection of the Single-Session Complete Ablation Rate by Contrast-Enhanced Ultrasound during Ultrasound-Guided Laser Ablation for Benign Thyroid Nodules:A Prospective Study[J].BioMed research international,2016,20(16):1-8.
[5]SPIEZIA S,VITALE G,DI S C,et al.Ultrasound-guided laser thermal ablation in the treatment of autonomous hyperfunctioning thyroid nodules and compressive nontoxic nodular goiter[J].Thyroid,2003,13(10):941-947.
[6]王琰,崔可飞,马笑.超声造影评分对甲状腺TI-RADS 4类结节良恶性的诊断价值[J].中国超声医学杂志,2015,31(10):880-883.
[7]GAMBELUNGHE G,FATONE C,RANCHELLI A,et al.A randomized controlled trial to evaluate the efficacy of ultrasoundguided laser photocoagulation for treatment of benign thyroid nodules[J].J Endocrinol Invest,2006,29(9):23-26.