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    影响无水乙醇消融治疗囊性为主甲状腺良性结节疗效的因素及对策

    The influencing factors of anhydrous ethanol ablation in the treatment of benign cystic thyroid nodules

    • 摘要: 目的探讨无水乙醇消融治疗囊性为主的甲状腺良性结节疗效的影响因素及对策。方法选择2014年1月至2016年6月在无锡市人民医院超声医学科行无水乙醇消融治疗的102例甲状腺结节患者作为研究对象,评价治疗前后的结节体积变化。比较单纯乙醇冲洗与乙醇冲洗加局部注射2种方法对甲状腺囊性为主良性结节的治疗效果,并分析影响2种治疗方法疗效的因素。结果无水乙醇消融治疗后,甲状腺结节平均体积从(15.7±14.3)ml减少到(3.0±2.5)ml,治疗有效率为84.5%。其中,单纯乙醇冲洗组甲状腺结节的平均体积从(16.6±13.5)ml 缩小至(4.7±3.1)ml,治疗有效率达76.9%。乙醇冲洗加局部注射前后甲状腺结节的平均面积从(14.8±12.2)ml 缩小至(2.1±1.4)ml,治疗有效率达90.2%,乙醇冲洗加局部注射的治疗疗效高于单纯乙醇冲洗。对所有的结节而言,无水乙醇消融治疗疗效的独立预测因素包括治疗的方法、治疗前体积和实性成分。治疗前体积和实性成分是单纯乙醇冲洗治疗疗效的独立预测因素,没有独立的因素与乙醇冲洗加局部注射的疗效有关。结论单纯乙醇冲洗与乙醇冲洗加局部注射甲状腺囊性为主的结节具有疗效,单纯乙醇冲洗对体积大、实性成分多的甲状腺结节有效率低于乙醇冲洗加局部注射,乙醇冲洗加局部注射可提高无水乙醇消融甲状腺囊性为主的良性结节的疗效,且不受结节性质影响。

       

      Abstract: Objective To investigate the influencing factors of anhydrous ethanol ablation in the treatment of benign cystic thyroid nodules and possible measures. MethodsA total of 102 benign cystic thyroid nodules patients who were treated with anhydrous ethanol in our department from January 2014 to June 2016 were enrolled in the study. The patients underwent ethanol flush or ethanol flush combined with local injection and their changes in the volume of nodules were evaluated before and after treatment, and the corresponding efficacies were compared. Meanwhile, the influencing factors of the above treatments were analyzed. ResultsAfter anhydrous ethanol ablation, the average volume of nodules were reduced from (15.7 ± 14.3) ml to (3.0 ± 2.5) ml, with an effective rate of 84.5%. Ethanol flush alone resulted in decreases in the average nodule volume from (16.6 ± 13.5) ml to (4.7 ± 3.1) ml, with an effective rate of 76.9%. Ethanol flush combined with local injection resulted in decreases in the average nodule volume from (14.8±12.2) ml to (2.1 ±1.4) ml, with an effective rate of 90.2%. The combined treatment showed a higher effective rate than ethanol flush alone. The independent predictors for the efficacy of anhydrous ethanol ablation include therapeutic methods, the volume before treatment volume and solid components of the nodules, where the volume before treatment volume and solid components of the nodules were the independent predictors for the efficacy of ethanol flush alone. No independent factor was found to be associated with the efficacy of the combined treatment. ConclusionsBoth ethanol flush and ethanol flush combined with local injection are effective to treat benign cystic thyroid nodules. Compared with ethanol flush alone, the combined treatment is more effective to treat nodules with large size or more solid components.

       

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