孙艳华滨州医学院烟台附属医院超声科，山东烟台　264100

超声引导下射频消融甲状腺结节的临床应用分析

孙艳华
滨州医学院烟台附属医院超声科，山东烟台264100

[摘要]目的分析采用超声引导射频消融（RFA)治疗甲状腺结节的临床疗效。方法整群选取48例2013年7月—2014年4月进入该院接受甲状腺结节肿瘤治疗的患者，所有患者颈部皮肤及皮下组织切开1 mm，在结节中心部位射频针穿刺并开启射频，控制应用能量为4~6 W，中心温度95℃。结果所有患者均成功接受RFA手术，术中未产生明显并发症。观察患者术后6个月，结节的体积较治疗前不同程度缩小，差异有统计学意义(P<0.05），47.9%（23/48）患者结节消失，27.1%（13/48）患者结节与术前比较缩小超过50%,25.0%（13/48)患者结节与术前比较缩小了20%~50%。结论超声引导射频消融治疗甲状腺结节肿瘤具有明显的治疗效果，值得进一步研究及在临床上应用推广。

[关键词]甲状腺结节；超声引导；射频消融

Analysis of Efficacy of Doppler Ultrasound-guided Radiofrequency Ablation for Nodular Goiter

SUN Yan-hua
Department of Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong Province, 264100 China

[Abstract]Objective To analyze the efficacy of Doppler ultrasound-guided radiofrequency ablation (RFA) in the treatment of nodular goiter. Methods 48 patients with nodular goiter who underwent tumor treatment in the hospital between July 2013 and April 2014 were included. An incision of 1 mm was made on the neck skin and subcutaneous tissue in all the patients. Radiofrequency needle were punctured into the nodule center and began to work, controlling a energy of 4~6 W and a center temperature of 95℃. Results The RFA was performed successfully on all the patients without obvious intraoperative complications. After 6 months treatment, the nodules decreased in varying degree in all the patients, and compared with those before treatment ,there were statistically significant differences. Nodules were found disappeared in 47.9% (23/48) patients, 27.1% (13/48) patients were noted with 50% nodule disappeared in size term, 25.0%（13/48) patients were found with 20% to 50% nodule disappeared in size term. Conclusion Doppler ultrasound-guided RFA is worthy of further promotion due to its good effect in treatment nodular goiter. [Key words] Benign thyroid nodules; Ultrasound guidance; Radio frequency ablation

一般治疗甲状腺结节的方法是采用腔镜甲状腺腺叶切除术，但随着医疗技术的发展，越来越多的学者认为颈部无瘢痕腔镜甲状腺手术因其手术时间长、术后疼痛剧烈、剥离面大而不能称之为微创手术，反而是一种创伤很大的手术[1]。该研究整群选取48例2013年7月—2014年4月进入该院接受甲状腺结节肿瘤治疗的患者，采用超声引导射频消融（RFA)治疗，取得非常好的临床效果，现报道如下。

1　资料与方法

1.1一般资料

整群选取48例进入该院接受甲状腺结节肿瘤治疗的患者，男20例，女28例，年龄为18~55岁，平均年龄33岁。对患者进行常规检查，有40例患者颈部可触摸到肿块，凸起影响美观，有8例患者颈部能感到疼痛及异物存在；肿瘤大小为1.1~2.3 cm，平均1.6 cm；其中，多发结节患者34例，单发结节患者14例；囊性13例，囊实性17例，实性18例。……