| Chapter 1 Comparison of Ultrasound-guided Microwave Ablation With Surguical Removal of Benign Thyroid NodulesObjective:To explore the value of ultrasound-guided microwave ablation and surgical resection in benign thyroid nodules.Methods:Retrospective analysis was performed on 54 patients admitted to our hospital from October 2015 to October 2018 who were pathologically confirmed to be benign thyroid nodules.There were 21 patients with left lobe nodule,10 patients with right lobe nodule,and 23 patients with bilateral lobe nodule.All the nodules were confirmed to be benign thyroid nodules by pathological biopsy or major pathology.Among them,27 patients wereselected as the ablation group after ultrasound-guided microwave ablation.The other 27 patients were treated with open surgery and were set as theoperation group..Thetreatment indicators of the two groups were analyzed,including operation time,hospital stay,hospital expense,intraoperative blood loss and postoperative pain(Prince-Henry score),thyroid function,postoperative complications,parathyroid function and quality of life.Results:The operation time(30.25±6.37)min of Ablation group is shorter than that in operation group(80.67±10.69)min(P<0.01),length of hospital stay(7.56±2.74)d is lower than the operation group(12.69±2.39)d(P<0.05),the ablation group hospitalization expenses(2041.39±200.41)yuan lower than the operation group(3526.85±210.59)yuan(P<0.01),bleeding amount of ablation group(1.89±0.54)ml less than operation group(14.07±0.44)ml(P<0.01);Postoperative pain score(2.61±0.12)in the ablation group was lower than that in the operation group(4.38±0.36)(P<0.05).The results showed that ablation group was better than the operation group,and the difference was statistically significant The level of triiodinated thyroprogenine(T3)in the operation group was lower than that before the operation one month after the operation and the difference was statistically significant(P<0.05)indicating decreased thyroid function in the operation group after the operation.The changes of triiodinated thyroxine(T3),thyroxine(T4)and thyrotrophin(TSH)levels in the ablation group before and 1 month after surgery were not statistically significant(P>0.05).Perioperative postoperative complications:1 case of postoperative recurrent laryngeal nerve injury caused hoarseness in the ablation group,2 cases of postoperative dysphagia in the operation group,3 cases of hoarseness in the operation group,1 case of postoperative massive bleeding,underwent secondary surgical rescue,and 6 cases of postoperative effusion in the operation group.In the ablation group,1 case had decreased blood calcium,indicating that the parathyroid gland was damaged.The number of postoperative effusion cases in the ablation group was lower than that in the operation group,and the difference was statistically significant(P<0.05).Quality of life survey The scores of emotional function(RE)and mental health(MH)in the ablation group were higher than those in the operation group,with statistically significant differences(P<0.05).Conclusion:Compared with open surgical treatment,ultrasound-guided microwave ablation of benign thyroid nodules can shorten the operation and hospital stay,cost less,reduce intraoperative blood loss,relieve postoperative pain,no effect on thyroid function,reduce the incidence of postoperative complications,improve the quality of life of patients,and have significant clinical application value.Chapter 2 The Effect of Microwave Ablation Power On The Ablation of Thyroid BenignPurpose:This paper retrospectively analyzed the cases of benign thyroid nodules ablation under different power settings,and observed the volume reduction rate of the nodules after ablation,in order to find the best appropriate power for inactivation of tumor cells of benign thyroid nodules,and to evaluate the long-term efficacy of ablation of benign thyroid nodules under different power settings.Methods:A retrospective analysis was performed on 14 cases(17cases)of benign thyroid nodules ablated by microwave with a power of 30W in our hospital,which were set as group 30W.We adopt 40W power microwave ablation of 15 patients with benign thyroid nodules(17),set to 40Wgroup,melting the center temperature is about 80℃-85℃,For thyroid nodules larger than 2 cm in diameter,the method of mobile ablation was adopted The ablation time at eath point was 10 seconds,respectively in postoperative lmonth,3month,6month,12month for regular ultrasound,measuring ablation area size,evaluation of thyroid nodule volume reduction rate(VRR)of ablation area.Results:The volume reduction rates in the 30W group were 33.44±42.17%,64.80±26.21%,79.56±20.96%,and 85.57±15.88%,respectively,at 1,3,6 and 12 months of follow-up.In the 40W group,the volume reduction rate was about 48.11±32.40%,64.46±33.42%,71.84±25.31%,and 78.08±18.88%,respectively,at the follow-up of lmonth,3 months,6 months and 12 months,respectively.The volume of nodules in both groups decreased with time(Pa<0.05),and the volume reduction rate increased with time(Pc<0.05).Compared with the 40W group,there was no statistically significant difference in volume reduction degree between the 30W group and the 40W group(Pb>0.05),and no statistically significant difference in volume reduction rate between the two groups(Pd>0.05).The results were as follows:for the larger(maximum diameter>2.0cm)benign thyroid nodules,there was no significant difference in the short,medium and long-term efficacy of 30W and 40W microwave ablation power.Conclusion:In this study,groups 30W and 40W of microwave could reduce the volume of benign thyroid nodule ablation in the short,medium and long term,and there was no significant difference in the therapeutic effect under the two power conditions. |
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