Clinical Study Of Microwave Ablation For Benign Thyroid Nodules

Objective: To explore the clinical efficacy of microwave ablation of benign thyroid nodules,ablation strategies of dangerous sites and the prevention and treatment of complications.Methods: By retrospectively analyzing the related information about 63 patients with thyroid benign nodules,who were treated by ultrasonic intervention succor microwave ablation and 68 patients treated of benign thyroid nodules traditional surgical operation in January 2016-January 2017 in the first hospital of Lanzhou university,the patient nodule number,size,location,calculated the volume of a nodule size were recorded and the data were analyzed.All the patients with microwave ablation has the pathological results before surgery,proved to be benign,and those of the patients after surgery proved to be benign too.After 1 month,3months,6 months,12 months and 18 months of regular follow-up,the following contents were clarified:1.To observe the dynamic change trend of thyroid nodule volume and volume reduction rate with time before and after ablation at 1,3,6,12,and 18 months.2.To compare changes of thyroid function before and after ablation,and thyroid function changes were compared between the two groups after ablation and surgery.3.To compare and analyze the differences in postoperative complications,operative time,length of stay,size of neck scars and blood loss between the two groups.4.To analyze the ablation strategy of the dangerous nodules and the prevention and treatment of complications.Results:1.No contrast agent perfusion was observed after cues' in the ablation group.CDFI: no obvious bleeding signal.The average volumes of thyroid nodule were 2.43 ml and 1.92 ml,1.33 ml and 0.61 ml,0.48 ml and 0.38 ml before and after 1,3,6,12,18 months of ablation surgery.After ablation the volume of thyroid nodule was diminishing along with the change of follow-up time,shrink rate were 20.98%45.37% 75.12%,80.10% and 84.30%,three nodules,(3/66,4.55%)were melted away in the follow-up of 6 to 18 months.2.After and before ablation,free triiodothyroiine,free thyrotropin and thyrotropin were all within the normal range.In the ablation group,free triiodothyroiine and free thyroidine were all higher than those in the surgery group,and thyroidine was lower than those in the surgery group,which has statistically significant differences(P<0.05).3.There was no statistically significant difference in the incidence of complications(hematoma,infection,hoarseness,parathyroid damage)between the two groups(P>0.05).The incidence of hypothyroidism in the ablation group was 0%(0/63),10.29% in the surgery group(7/68),the incidence of hypothyroidism in the ablation group was lower than that in the surgery group(?2= 4.967,P = 0.026),and the total incidence of complications in the ablation group was lower than that in the surgery group,which has statistically significant difference(?2= 5.5941,P = 0.018).The mean length of hospital staying between the two groups was statistically significant(P<0.05),and the ablation group was significantly lower than the surgery group.Almost no scars were left in the ablation group,and 5-7cm horizontal scars were left in the surgery group,which has statistically significant differences(P<0.05).Conclusion: Comparison of hospitalization time,postoperative scar,operation time and bleeding volume.1.During the postoperative follow-up of the ablation group,the thyroid nodules were significantly reduced gradually,with 3 nodules completely disappeared during the postoperative follow-up.All the nodules disappeared after operation in surgery group.Microwave ablation and surgical resection of thyroid nodules can effectively eliminate thyroid benign nodules,but the efficacy of microwave ablation surgery needs long-term observation.2.There is no significant difference in thyroid function after microwave ablation for thyroid nodules compared with that before surgery.While microwave ablation is effective in treating thyroid nodules,it also retains thyroid's function.Surgical resection for thyroid's function is more harmful.3.During the treatment of benign thyroid nodules with microwave ablation,the preoperative risk assessment of nodules was performed well,and the use of liquid dissociation zone and lever dissociation as well as the injection of lauromacrogol at the dangerous site could effectively reduce the occurrence of complications.4.The treatment of benign thyroid nodules by percutaneous microwave ablation under the guidance of ultrasound has advantages of accuracy,aesthetics,less complications,less trauma,short hospitalization time and repeatable operation,which is effective and can be popularized in clinical practice,but its long-term efficacy remains to be further followed up for observation.