Clinical Study Of Microwave Ablation In The Treatment Of Benign Thyroid Nodules

Objective:To study the effect of percutaneous microwave ablation in the treatment of thyroid benign nodules under ultrasound guidance, thyroid function and complications,and compared with the same period of surgery patients with aesthetic effects, pain and surgical anesthesia response score.Methods:November 2015 to November 2016 period, Selected in the hospital implementation of microwave ablation of thyroid benign nodules in patients with a total of 56 cases of 72 nodules.Operation process: Preoperative ultrasound guided subcutaneous needle aspiration cytology, to determine the nodular nature, According to the size and location of lesions,develop a treatment plan, ablation according to the ablation process.Postoperative follow - up and efficacy evaluation:Patients were followed up for 1 month, 3 months, 6 months and 12 months after ablation, color doppler ultrasonography was used to measure thyroid nodule size, border, internal echo, blood flow, and in the first month after surgery, take ceus to assess nodular microvascular damage and whether there is neovascularization, statistical ablation area volume,volume reduction rate, thyroid function, complications, and compared with the same period of surgery patients with pain, anesthetic response and aesthetic effect score.Results:1.Ultrasound performance: After the completion of ablation, the original mass of the region where the group was strong echo area, clear boundary, the rear echo was mildly attenuated,and the follow-up showed a clear low echo. Color Doppler ultrasound showed that the internal color flow signal disappeared, peripheral non-ablation area blood flow signal normal.2.Lesion absorption: 1) Since the first month after microwave ablation, the nodule volume began to decrease. The follow-up results showed that the volume of nodules in the ablation area was different in 1 month, 3 months, 6 months and 12 months Progressive reduction,the volume reduction rate was 40.4%, 58.61%, 75.8%and 71.81%, respectively, which were statistically significant (P <0.05),and the rate of reduction was the fastest in 6 months (P <0.05 vs 3 months), the rate of reduction was slower in 12 months (P> 0.05 vs 6 months). 2) During the follow-up period, 39 nodules were completely absorbed, the absorption rate was 54.17% (39/72), 13 nodules were less than 12 months, and the recurrence rate was 4.17% (3/72). 3) After 1 month, 3 months,the volume reduction of mixed nodules was more significant than that of solid nodules, but the percentage reduction in the two types of nodules was not significant after 3 months Statistical differences. 4) Diameter of 0 ?20mm and 31?40mm group at 1 month after the ablation area of the volume reduction degree is more significant than the other group, and diameter 0?20mm group at 6 months after the ablation area of the volume reduction rate is greater than the other two diameter group,there was no significant difference in the percentage of volume reduction between the three types of nodules.3.Thyroid function: Although the thyroid nodule microwave ablation treatment will cause a small amount of normal surrounding gland tissue injury, but no significant impact on thyroid function, no clinical symptoms.4.Complication: 1) During the operation,11 cases (19.64%) were changed,and the self-relief disappeared after 1?2h; 2) In the early stage, 4 patients (7.14%)developed dysphonia and hoarse voice after 6 to 48 h after surgery, after 1 to 3 months treatmented,the sound returned to normal; 3) 3 cases (5.37%) appeared skin burns; 4)9 cases (16.07%) had vasovagal responses;5) Seven patients (12.5%) developed pain,with lidocaine remission;6) all patients after localized varying degrees of regional swelling, to ice and compression after treatment to reduce symptoms.5. Subjective evaluation of the effect of postoperative: Through the same period of surgical patients with benign disease and ablation group were compared,we found that the ablation group in the aesthetic effect,pain and surgical anesthesia response score were significantly better than the operation group, the difference was statistically significant (P <0.05)Conclusions:1.After 6 months,the ablation area to absorb faster,then the absorption rate is slow, so after 6 months can be used as thyroid benign nodule microwave ablation after the evaluation of the absorption of an important time point.2. Microwave ablation in the aesthetic effect, pain and surgical anesthesia response score after the subjective evaluation of the effect is better than surgery, to achieve good minimally invasive effect.3.Contrast Enhanced Ultrasonography is a method of detecting microvascular infusion in the lesion. It can clear the residual lesion and supplement the ablation during operation. It can also evaluate the extent of ablation and understand the recurrence of follow-up.4.Ultrasound-guided microwave ablation of benign thyroid nodules is an effective treatment, appearance, fewer complications of treatment, under the premise of a good grasp of indications can be used as a new treatment.