超声引导下RFA及开放性手术对甲状腺微小乳头状癌患者甲状腺功能的影响

doi:10.3969/j.issn.1671-7171.2023.12.031

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摘要【目的】探讨超声引导下射频消融(RFA)及开放性手术对甲状腺微小乳头状癌患者甲状腺功能的影响。【方法】选取2020年3月至2022年2月本院收治的90例甲状腺微小乳头状癌患者,依据手术方式的不同将其分为观察组和对照组,每组45例。对照组行开放性手术治疗,观察组行超声引导下RFA治疗。比较两组患者围术期指标,比较两组患者手术前后甲状腺功能[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT₃)和游离甲状腺激素(FT₄)],比较两组患者手术前后血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平,比较两组患者并发症发生情况。【结果】观察组患者手术时间、术中出血量、住院时间及住院费用均高于对照组,差异有统计学意义(P<0.05)。对照组患者术后TSH水平显著高于同组术前,而FT₃、FT₄水平则低于同组术前,差异有统计学意义(P<0.05);观察组术后TSH水平显著低于同组术前,差异有统计学意义(P<0.05);观察组术后TSH水平显著低于对照组,FT₃、FT₄水平则显著高于对照组,差异有统计学意义(P<0.05)。两组患者术后血清IL-6、TNF-α、CRP水平均高于同组术前,差异有统计学意义(P<0.05);观察组术后血清IL-6、TNF-α、CRP水平均低于对照组,差异有统计学意义(P<0.05)。观察组患者并发症发生率低于对照组,差异有统计学意义(P<0.05)。【结论】超声引导下RFA治疗甲状腺微小乳头状癌患者对甲状腺功能的影响较小,术后并发症少,安全性高。

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	陈姗姗
	蔡永胜
	何宁

关键词 ：甲状腺肿瘤/外科学, 导管消融术, 甲状腺功能试验

Abstract：【Objective】To investigate the impact of ultrasound-guided radiofrequency ablation (RFA) and open surgery on thyroid function in patients with thyroid micropapillary carcinoma. 【Methods】A total of 90 patients with thyroid micropapillary carcinoma admitted to our hospital from March 2020 to February 2022 were selected and divided into an observation group and a control group according to different surgical procedures, with 45 cases in each group.The control group underwent open surgery, while the observation group underwent ultrasound-guided RFA treatment.Perioperative indicators were compared between the two groups, as well as thyroid function before and after surgery [thyroid-stimulating hormone (TSH), free triiodothyronine (FT₃), and free thyroxine (FT₄)].The levels of serum inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP)] were compared before and after surgery, as well as the incidence of complications. 【Results】The operation time, intraoperative blood loss, hospitalization time, and hospitalization costs in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). The postoperative TSH level in the control group was significantly higher than that in the same group before surgery, while the FT₃ and FT₄ levels were lower than those in the same group before surgery, and the difference was statistically significant (P<0.05). The postoperative TSH level in the observation group was significantly lower than that in the same group before surgery, and the difference was statistically significant (P<0.05). The postoperative TSH level in the observation group was significantly lower than that in the control group, while the FT₃ and FT₄ levels were significantly higher than those in the control group, and the difference was statistically significant (P<0.05). The levels of serum IL-6, TNF-α, and CRP in both groups were higher than those before surgery, and the difference was statistically significant (P<0.05). The postoperative serum IL-6, TNF-α, and CRP levels in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). The incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】Ultrasound-guided RFA treatment for thyroid micropapillary carcinoma has less impact on thyroid function, with fewer postoperative complications and high safety.

Key words： Thyroid Neoplasms/SU Catheter Ablation Thyroid Function Tests

收稿日期: 2022-08-25

中图分类号:

R736.1

引用本文:

陈姗姗, 蔡永胜, 何宁. 超声引导下RFA及开放性手术对甲状腺微小乳头状癌患者甲状腺功能的影响[J]. 医学临床研究, 2023, 40(12): 1929-1932.
CHEN Shanshan,CAI Yongsheng,HE Ning. The Effect of Ultrasound-guided RFA and Open Surgery on Thyroid Function in Patients with Thyroid Micropapillary Carcinoma. JOURNAL OF CLINICAL RESEARCH, 2023, 40(12): 1929-1932.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.12.031 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I12/1929

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