| Objective:To make a comparative observation on the efficacy and safety between ultrasound guided percutaenous lauromacrogol injection (PLI) and percutaenous ethanol injection (PEI)for thyroid cysto-changes, and to analyze the factors affecting treatment efficacy.Materials and Methods:Executing conventional ultrasound on 62 thyroid cystic or cystic primarily nodules in 62 cases of cystic lesions in patients, who have been treated by the ultrasound-guided percutaneous sclerotherapy. To observe the lesion location, size, shape and characteristics of internal echo, internal and peripheral blood supply with color doppler flow imaging examination. According to random number table,62 patients were divided into the following groups:30 patients with lauromacrogol treatment as group A, included 11 male patients and 19 female patients, the average age was (47.4±9.7) years; 32 patients with ethanol treatment as group B, included 14 male patients and 18 female patients, the average age was (51.5±11.1) years. Ultrasound-guided injection of ethanol and lauromacrogol were respectively for injected in group A and group B for sclerotherapy, observing the intra-operative adverse reactions. After the treatment, the patients were followed up to observe the changes in the size of cysts and analyze the factors affecting their efficacy, including gender, age, number of, location (isthmus, left, right), the volume of initial cavity, intracavitary situation (simplex:no separated, complexity:septation or floccule echo), wall case (rules, irregular) and the cyst fluid (thin, thick).Result:1.62 cases of patients were once successful puncture, and the pathological examination of cyst fluid showed no cancer cells. In addition all patients had no complications such as surrounding blood vessels broken, trachea injury, recurrent laryngeal nerve injury. In group A,2 patients felt comfort, except the pain of the puncturing part. Therefore, the side effect rate (SER) of group A was 6.7%(2/30); In group B, sting pain or distending pain occurred in 9 patients. In details, there are 3 patients experienced few drunk-like reactions like flushing, dry mouth, etc. And 1 patient appeared swelling neck, which was showed as edema by the thyroid ultrasound. By giving 3d antibiotic, the patient achieved remission of symptoms finally. Therefore, the side effect rate (SER)of group B is 28.1%(9/32).There was significant difference between group A and group B (P<0.05).2. A group lauromacrogol treated 30 nodules cysts before treatment the average volume of 19.9±21.7ml, one week later reduced to 5.8±8.7ml, after one month narrowed to 1.7±2.4ml, after three monthes to 1.0±1.9ml, and after six monthes to 0.9±2.7ml, The sclerotherapy completely cure rate (CCR) was 86.7%(26/30) and the overall response rate (ORR) was 90.0%(27/30) at last follow-up. Group B ethanol treatment group 32 thyroid nodules before treatment cavity volume of 20.1±21.1ml, one week later reduced to 4.7±8.0ml, after one month narrow to 1.7±2.1ml, after three monthes to 1.2±2.5ml, and after six monthes to 1.0±2.5ml.The sclerotherapy completely cure rate (CCR) was 84.3%(27/32) and the overall response rate (ORR) was 90.6%(29/32) at last follow-up. The completely cure rate and the overall response rate between the group A and group B have no statistically significant difference (P>0.05).3. In group A and group B, the situations of the cyst wall, internal cyst and the cyst fluid are important factors influencing the efficacy of thyroid cysto-changes.Conclusion:1. The percutaenous lauromacrogol injection (PLI)and the percutaenous ethanol injection (PEI) both have good curative effect on thyroid cysto-changes, and both of them have no difference on curative effect.2. Less side effects was found in the percutaenous lauromacrogol injection (PLI), so the patients was easily accepted it. It is expected to be a substitute for anhydrous ethanol in sclerotherapy of thyroid cysto-changes.3. In both groups the irregular cystic wall, complex cystic cavity and the fluid viscous are important factors affecting the efficacy in the treatment of thyroid cyso-changes. |
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