CAJ | 학술논문

目的：探讨微波消融治疗甲状腺良性结节的方法步骤、安全性及临床效果。方法对1250例2173枚甲状腺良性结节，在超声引导下经皮穿刺活检后行微波消融治疗，并就适应证、术前准备、穿刺路径、麻醉方法（尤其“低浓度低容量麻醉法”的选择）、“液体隔离带”法的应用，以及消融术相关的并发症、疗效进行分析比较。结果微波消融治疗后1、3、6、12、18、24个月，甲状腺结节体积均有不同程度缩小，体积缩小率分别为11．4％、28．6％、50．3％、79．1％、83．2％、94．2％；“低浓度低容量”麻醉法及“液体隔离带”的应用，有效减少了声音嘶哑等并发症的发生，初期发生率为0．48％（6／1250）。所有病例均未发生永久性声音改变，无食管烧伤、气管食管瘘等严重并发症，无甲状腺功能损害及甲状旁腺功能损害。结论超声引导下甲状腺结节微波消融治疗安全性高，创伤小，可控性强，疗效确切。具有广阔的临床应用前景。
목적：탐토미파소융치료갑상선량성결절적방법보취、안전성급림상효과。방법대1250례2173매갑상선량성결절，재초성인도하경피천자활검후행미파소융치료，병취괄응증、술전준비、천자로경、마취방법（우기“저농도저용량마취법”적선택）、“액체격리대”법적응용，이급소융술상관적병발증、료효진행분석비교。결과미파소융치료후1、3、6、12、18、24개월，갑상선결절체적균유불동정도축소，체적축소솔분별위11．4％、28．6％、50．3％、79．1％、83．2％、94．2％；“저농도저용량”마취법급“액체격리대”적응용，유효감소료성음시아등병발증적발생，초기발생솔위0．48％（6／1250）。소유병례균미발생영구성성음개변，무식관소상、기관식관루등엄중병발증，무갑상선공능손해급갑상방선공능손해。결론초성인도하갑상선결절미파소융치료안전성고，창상소，가공성강，료효학절。구유엄활적림상응용전경。
Objective To investigate the method,steps,safety and clinical effect of ultrasound-guided microwave ablation for benign thyroid nodules. Methods Ultrasound-guided microwave ablation was conducted following tru -cut biopsy of 2173 benign thyroid nodules in 1250 patients. The indications,preoperative preparation,the puncture route,the ways of anesthesia administration (specially,the options of "low concentration of low-volume anesthesia method"),the application of “liquid isolation”,the complications related to ablation and therapeutic effect were analyzed and compared. Results After microwave ablation for 1,3,6,12,18,24 months,the size of thyroid nodules were shrunk to various degrees,the loss of volume rate was 11.4%,28.6%,50.3%,79.1%, 83.2%,94.2%,respectively. The application of "low concentration of low-volume anesthesia method" and "liquid isolation",effectively reduced the occurrence of complications such as hoarseness,initial rate of 0.48%. None of the cases with a permanent voice change,esophageal,tracheal esophageal fistula and other severe complications were found. No dysfunction of the thyroid and parathyroid were also found. Conclusion Ultrasound-guided microwave ablation is a safe,minimally invasive,controllable and definitely effective method for treating benign thyroid nodules. It has a great clinical potential.