Application Of Radiofrequency Ablation In The Treatment Of Benign And Malignant Thyroid Nodules

Part 1 Clinical effect of radiofrequency ablation in the treatment of papillary thyroid microcarcinoma with Hashimoto's thyroiditisObjective:To investigate the efficacy and safety of Hashimoto's thyroiditis combined with PTMC radiofrequency ablation.Materials and Methods:76 patients with PTMC who underwent RFA treatment in the Department of Ultrasound,Chinese PLA General Hospital from January 2017 to January 2018 were enrolled.All patients had complete follow-up records with exact pathology and BRAP-V600E monitoring results.Pathology was used as the gold standard.According to whether PTMC was combined with HT,it was divided into tAvo groups,namely,the bridge group(n=38)and the control group(n=38).The age,sex,seven tasks,the maximum diameter of nodules,the volume of nodules,the time of radiofrequency ablation,the energy used,the time imnediately after ablation,and the volume and reduction rate of the lesions at 1,3,6,and 12 months after surgery were counted.Ultrasound angiography was used to evaluate the extent of lesion destruction after ablation,and to detect residual or recurrence.The complications during intraoperative,postoperative and follow-up were recorded.All patients underwent multi-point biopsy pathological examination at 3 months postoperatively.In addition,the groups were regrouped according to whether other nodules were combined,and the rate of reduction of the lesions at 1,3,6,and 12 months after surgery were compared.Results:1.There was no significant difference in gender,age,nodule maximum diameter and nodule volume between the Hashimoto group and the control group(P>0.05).2.The reduction rate of the bridge group was 1 month and 3 months after operation.The controlgroup was small,the difference was statistically significant(P<0.05).There was no significant difference in the reduction rate between 6 months and 12 months after operation(P>0.05).3.Whether other nodule reduction rate was combined in the group.The difference was not statistically significant(P>0.05);4.No serious complications occurred.Of the two groups,6 patients had different degrees of pain after surgery and were relieved after symptomatic treatment;2 patients had transient hoarseness and recovered within 30 minutes after surgery;no skin bums occurred and no effect on breathing Hematoma formation,no cases of peripheral blood vessels and nerve damage.Conclusion:Radiofrequency ablation of HT with PTMC is a safe and effective minimally invasive treatment.Part 2 The effective and security comparative analysis of Benign cystic solid Thyroid Nodules:Radiofrequency Ablation and Combined Absolute EthanolObjective:To evaluation the effective of radiofrequency ablation combined with absolute ethanol so as to provide a theoretical basis for the combined ablation.Materials and Methods:71 benign thyroid cystic solid nodules confirmed by pathology were divided into radiofrequency ablation group(n=44)and the group treated with the combination of ethanol(n=27)and the aspects such as intraoperative bleeding,radiofrequency energy,and postoperative lesion reductionrate were compared in the study.Results:No significant difference existed in the reduction rate of thyroid nodules between the radiofrequency ablation group and the group treated with the combination of ethanol(P>0.05);nor did the effect of cystic proportion upon postoperative lesion reduction(P>0.05).The difference of time[149.5(92.5?206.3)s vs 295(136?531)s]and the consumption of energy[0.88(0.59?1.43)kJ vs 1.90(0.76?3.32)kJ]between the group treated with the combination of ethanol and radiofrequency ablation group have statistic significance(p<0.05).Conclusion:The ablation of ethanol before radiofrequency ablation in treating thyroid cystic solid nodules has no significant effect on the reduction rate of nodules,but it can significantly shorten operation time and consume less energy.