良性囊性甲状腺结节治疗方式选择与效果比较

Comparison of treatment efficacy for benign cystic thyroid nodules: polidocanol sclerotherapy versus radiofrequency ablation

关键词:  消融  超声  甲状腺结节  体积缩小率

Key words:  ablation  ultrasound  thyroid nodules  volume reduction rate

摘要:

目的分析聚桂醇硬化和射频消融在治疗良性囊性甲状腺结节中的实际应用疗效,并探讨患者对治疗方式的选择。 方法回顾性选择2017年9月—2023年10月在上海中医药大学附属曙光医院接受硬化和射频治疗的良性囊性甲状腺结节患者。共纳入86例患者（99个结节）,根据患者的治疗意愿分为硬化组（70个结节）和射频组（29个结节）。随访12个月,比较两组的结节体积缩小率、手术时长、治疗费用、复发率、美容问题改善以及主要并发症的数量,并分析患者对治疗方式的偏好。 结果硬化组的平均体积减少为83.5%（21例）,射频组为89.5%（17例）,两组之间的差异无统计学意义。与射频组相比,硬化组在治疗时长和治疗费用方面表现出更大的优势。两组患者的美容评分和复发率差异均无统计学意义（P=0.823和P=0.191）。两组均未发生重大并发症。 结论硬化治疗费用更低、治疗时间更短,年龄较大的患者更倾向于选择硬化治疗。

Abstract:

ObjectiveTo compare the therapeutic efficacy of polidocanol sclerotherapy and radiofrequency ablation in treatment of benign cystic thyroid nodules, and to explore the patients preference for treatment options. MethodsA total of 86 patients with benign cystic thyroid nodules(99 nodules) who underwent polidocanol sclerotherapy(70 nodules) or radiofrequency ablation(29 nodules) in Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from September 2017 to October 2023 were enrolled in the study. The nodule volume reduction rate, surgical duration, treatment cost, recurrence rate, cosmetic improvement, and incidence of major complications were compared between the groups, and the preference of patients for treatment methods was analyzed. ResultsThirty eight patients were followed up for 12 months, there was no significant difference in the average volume reduction between the sclerotherapy group(n=21）and radiofrequency group（n=17）(83.5% vs 89.5%, P>0.05). The sclerotherapy group showed greater advantages over the radiofrequency group in treatment duration and costs. There were no significant differences in cosmetic scores and recurrence rates between the two groups (P=0.823 and P=0.191). No major complications occurred in both groups. ConclusionCompared to radiofrequency ablation, sclerotherapy is more cost-effective, requires a shorter treatment time, and is preferred by older patients.