Meta-analysis Of Non-surgical Treatment Methods For Benign Thyroid Nodules

Objective: To study the non-surgical treatment of benign thyroid nodules,such as levothyroxine suppressive therapy,percutaneous ethanol injection,radiofrequency ablation,radioiodine therapy.Changes in volume,cure rate,effectiveness,inefficiency,and complication rate are used to evaluate the effectiveness of each treatment method.Methods: A computer retrieval tool was used to search the pubmed database,Foreign Medical Journal Full-Text Service,Wanfang Medical Database,and China Knowledge Network(CNKI)with the keywords “thyroid nodule”,“benign”,“treatment” and their synonyms as keywords.All literatures related to the treatment of benign thyroid nodules published between January 1997 and December 2019.After literature screening and quality evaluation according to the inclusion and exclusion criteria,the data was analyzed using Rev Man 5.3 software provided by the Cochrane Center.Results: A total of 29 articles were included in this article,with a total of 2360 cases,of which 9 were related to levothyroxine(L-T4)suppressive therapy,and a total of 757 cases.The meta-analysis results showed that the effect scale SMD =-2.05,95 % CI [-3.00,-1.10],which is statistically significant.There are 8 literatures related to percutaneous ethanol injection under ultrasound guidance,with a total of 450 cases.Meta analysis results show that the cure rate is 57.6%,and the 95% CI is [38.3%-74.7%],effective rate is 86.0%,95% CI [65.0%-95.3%],ineffective rate is 5.7%,95% CI [2.91%-12.3%],complication rate is 5.7%,95% CI [3.84%-9.09%].There are 12 literatures related to radiofrequency ablation under ultrasound guidance,with a total of 1153 cases.The meta-analysis results show that the cure rate is 68.15%,95% CI [49.75%-82.14%],and the effective rate is 53.05 %,95% CI [32.43%-72.53%],the ineffective rate was 20.63%,95% CI [16.67%-25.37%],the incidence of complications was 9.09%,and 95% CI [3.85%-22.48%].Radioiodin related literature is not suitable for meta-analysis.Conclusions:1.Levothyroxine(L-T4)suppressive therapy can reduce the volume of benign thyroid nodules,but the related literature has not studied the specific effects of different treatment doses and treatment time on the treatment effect,nor has it studied the long-term thyroid hormone suppression therapy for bone and The adverse effects of the cardiovascular system must be carefully weighed against the expected benefits and potential adverse effects of the therapy.2.Percutaneous ethanol injection and radiofrequency ablation are effective in treating benign thyroid nodules,but there are certain complications during the treatment,so the operating physician is required to be proficient in operation,familiar with the neck structure,and able to cope with various complications Appears.3.Although the effectiveness and feasibility of radiofrequency ablation for the treatment of benign thyroid nodules has been gradually applied to the clinical treatment,due to the short time of this technology,a unified understanding has not yet been formed,and long-term effects are need to be confirmed by more clinical practice and research.