南方医科大学学报

南方医科大学学报 ›› 2022, Vol. 42 ›› Issue (10): 1578-1583.doi: 10.12122/j.issn.1673-4254.2022.10.20

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微波消融术前甲状腺良性结节的风险分级有临床价值

吴凤林，吴巧至，吴方竞，周 琳，许文伟，谢国勇，刘乐融，刘 颖，薛耀明   

  1. 南方医科大学南方医院内分泌代谢科，广东 广州 510515；南方医科大学附属第三医院妇产科，广东 广州 510630；南方医科大学公共卫生学院生物统计学系，广东 广州 510515
  • 出版日期:2022-10-20 发布日期:2022-11-01

Does preoperative risk grading have clinical value for benign thyroid nodular ablation?

WU Fenglin, WU Qiaozhi, WU Fangjing, ZHOU Lin, XU Wenwei, XIE Guoyong, LIU Lerong, LIU Ying, XUE Yaoming   

  1. Department of Endocrine and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; Department of Obstetrics and Gynecology, Third Affiliated Hospital, Southern Medical University, Guangzhou 510630, China; School of Public Health, Southern Medical University, Guangzhou 510515, China
  • Online:2022-10-20 Published:2022-11-01

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摘要： 目的 探讨甲状腺良性结节微波消融术前的风险分级方法及临床意义。方法 根据甲状腺结节的毗邻关系，术前将结节消融风险分为低风险、中风险、高风险和极高风险4级。记录术后严重并发症发生率及结节残留发生率。结果 527例甲状腺结节患者微波消融术后低、中、高和极高风险组的严重并发症的发生率为0%、0.88%、2.41%和6.78%，各组差异均无统计学意义（P>0.05）。术后低、中、高和极高风险组的结节残留发生率分别为1.59%、6.14%、14.43%和71.19%，其中低风险与中风险组差异无统计学意义（P>0.05）；但低风险、中风险组与高风险、极高风险组差异有统计学意义（P<0.001）。结论 甲状腺结节术前风险分级有助于术中严重并发症的预防及术后结节残留发生率的预估。

关键词: 甲状腺结节；微波消融；风险分级；并发症

Abstract: Objective To explore the risk grading method for benign thyroid nodules before microwave ablation and the clinical significance of risk grading. Methods This study was conducted among 527 patients undergoing ultrasound-guided microwave ablation of benign thyroid nodules between July, 2017 and December, 2020. Based on anatomic relationship of the thyroid nodules with the adjacent tissues, the ablation risk was classified into 4 levels: low, medium, high and extremely high risks. The incidence of severe complications and the rate of residual nodules following the ablation were recorded. Results In the patients graded to have low, medium, high and extremely high preoperative risks, the incidences of severe complications following the ablation were 0%, 0.88%, 2.41% and 6.78%, respectively, showing no significant differences among the different risk groups (P>0.05). The rates of postoperative residual nodules in the 4 risk groups were 1.59%, 6.14%, 14.43% and 71.19%, respectively, showing a significant difference between the low and medium risk groups and the high and extremely high risk groups (P<0.001). Conclusion Preoperative risk grading for thyroid nodular ablation can be helpful for prevention of severe complications during ablation and prediction of residual nodules after ablation.

Key words: thyroid nodules; microwave ablation; risk grading; complication