Comparative Study On Operative Trauma Of Ultrasound Guided Percutaneous Microwave Ablation With The Traditional Open Surgery For Benign Thyroid Nodules Influence Of Microwave Ablation And Open Thyroideetomies On Trauma

Objective: In recent years, microwave ablation has already become new important methods for treatment of benign thyroid nodules, microwave ablation by contrast, the patients are more rapid recovery, more little trauma and the incision is beautiful. As a kind of minimally invasive treatment, the microwave ablation has been accepted by more and more patients. But as the principle of thermal ablation treatment of thyroid benign nodules, the trauma on the body still exist. Specific trauma degree are lack of clinical experiment research. TNF- a,IL-6,CRP is a commonly indicators of reflecting degree of trauma by operation. Thyroid hormone is also an important index of thyroid post-traumatic, In order to investigate the influence of the two methods of treatment of trauma to the human body, we monitored the serum content of TNF- a,IL-6,CRP,TSH,T3,T4, f T3,f T4 before and after the operation.Methods: Without receiving any drug, 90 patients who got benign thyroid nodules in the general surgery department of the PLA 81 sthospital are observed before and after the microwave ablation group and traditional group, 45 patients choose microwave ablation and 45 patients choose traditional surgery..Using ELISA to test serum TNF-a,IL-6 and CRP, Examining TSH,T3,T4, f T3 and f T4 used by electrochemical luminescence.Results: Firstly Significant different was found between the 2 groups in the levels of,CRP, IL-6,and TNF- a after operation,[( 0.6±0.2) mg/L vs.( 11.9±2.1) mg/L, t=-35.934,P=0.000;(3.5 ± 1.2)ng/L vs.(14.3±4.4)ng/L, t=-15.885, P=0.000;(43.1 ± 6.1)ng/L vs.(50.1±2.7)ng/L, t=-7.039,P=0.000]; Secondly, The serum levels of TSH,T3,T4, f T3 and f T4 in microwave ablation group are(ng/L): 3.16 ± 0.98 、 2.43 ± 0.68 、 96.50 ±22.88 、 16.68 ± 2.16 、 16.68 ± 2.16;the other group are(ng/L): 3.31 ± 0.79 、 2.72 ± 0.74 、 96.80 ± 23.47 、 16.61 ± 2.35 、 16.61 ± 2.35, there are no significant statistical difference between the two groups. Thirdly, there are also significant difference between the two groups in blood loss, operation time, and post operation hospitalization duration[(12.3 ± 2.1)ml vs.(29.2 ± 4.1)ml, t=-24.610, P=0.000;(29.4 ± 5.4)min vs.(82.2 ± 14.8)min,t=-22.482, P=0.000;(1.6 ± 0.7) d vs.(4.2 ± 0.4) d, t=-21.633, P=0.000].While there was no significant difference in complications rates between the two groups: there are 4 in the microwave ablation group and 6 in the traditional open surgery(c2=0.450, P=0.502);Lastly, the microwave ablation group of volume-reduction ratio on average are 22.2%,52.3%, 68.2% and 52.3% after 1, 3, 6, 12 months of follow-up.Conclusions: Ultrasound guided percutaneous microwave ablation has definite curative effect, good safety, simple operation and fewer adverse reactions, it is a feasible technique for benign thyroid nodules.