Complications Of Ultrasound-guided Percutaneous Microwave Ablation For Benign Thyroid Nodules And The Causes Of Complications

Objective The retrospective study further summarizes the indications,surgical techniques,complications and related causes of ultrasound-guided thyroid microwave ablation therapy,and provides a clinical reference for the prevention and treatment of complications related to thyroid nodules by microwave ablation.Methods Statistical analysis was performed on 50 patients who underwent microwave ablation of benign thyroid nodules from October 2016 to October 2018 in the Department of Oncology,Yinchuan First People's Hospital.The incidence of intraoperative and postoperative complications,the location of the preoperative nodules and blood flow,surgical techniques,and puncture paths were used.The relationship between the blood flow of nodules and intraoperative and postoperative hemorrhage,the relationship between nodular position and recurrent laryngeal nerve injury,and the relationship between different puncture paths and hemorrhage and recurrent laryngeal nerve injury were analyzed.The relationship between the application of different surgical techniques and postoperative complications.Results 1.A total of 78 nodules were collected from 50 patients,all of which were successfully completed by microwave ablation.There was no case of open surgery.In the operation and postoperative patients,12 patients had pain,most of them were tolerated,and 2patients had to use analgesic drugs.5 cases of blood were delivered during and after surgery,and hemostasis can be stopped after compression.There were 3 cases of recurrent laryngeal nerve injury(including hoarseness,drinking water and cough),2 cases recovered within 12 hours after operation.One case of horner's syndrome occurred after operation and returned tonormal after 2 months..All cases had no complications such as hypothyroidism and puncture site infection.2.Different blood flow signals in the nodules are different from the incidence of intraoperative and postoperative bleeding.The incidence of nodular hemorrhage with multiple blood flow signals(grade 3)was significantly higher than the other groups(P < 0.05).Among them,the nodules of multiple blood flow signals had higher incidence of nodular hemorrhage than those without blood flow signals and visible punctate blood flow signals(P<0.05).The location of different nodules differed in the incidence of recurrent laryngeal nerve injury.The incidence of recurrent laryngeal nerve injury in the thyroid nodules(grade 4)close to the posterior capsule was significantly higher than that in the posterior medial thyroid capsule(P<0.05).3.The incidence of complications in the isthmus was smaller than that in the lateral neck(P<0.05).The incidence of complications using the lever distraction method was less than that of the untreated lever dissociation method(P<0.05).There was no significant correlation between the application of mobile ablation and the incidence of complications(P>0.05).The incidence of complications after application of the fluid barrier was less than that of the non-applied fluid barrier(P < 0.05).The incidence of complications under different preventive measures was not statistically significant(P>0.05).Conclusion1.The richer the blood flow of the nodule,the higher the incidence of bleeding risk;the closer the position of the nodule is to the tracheal esophageal sulcus,the greater the probability of recurrent laryngeal nerve injury;2.The isthmus is selected as the puncture path.The intraoperative application of the fluid isolation band and the lever separation method can reduce the occurrence of complications during microwave ablation and improve the safety of the operation.3.In the process of microwave ablation,the selection of appropriate preventive measures can reduce the incidence of intraoperative and postoperative complications.