首页|甲状腺癌术后患者行超声引导下射频消融侧颈区和中央区转移性淋巴结的有效性及安全性比较

甲状腺癌术后患者行超声引导下射频消融侧颈区和中央区转移性淋巴结的有效性及安全性比较

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背景 超声引导下射频消融(radiofrequency ablation,RFA)对甲状腺癌术后患者侧颈区与中央区的转移性淋巴结(cervical lymph nodes metastasis,CLNM)疗效的对比研究较少.目的 评估RFA对甲状腺癌全切术后侧颈区和中央区CLNM的治疗效果和并发症发生情况.方法 回顾性分析 2020年 1月—2021年 1月在解放军总医院第一医学中心超声诊断科行RFA治疗甲状腺癌全切术后发生侧颈区和中央区CLNM的患者,随访截至 2023年 1月 1日,对比两组患者消融前后的CLNM体积和消融后体积缩小率(volume reduction rate,VRR)以及消融时和随访中的并发症发生情况.结果 共 52例患者(96枚CLNM)纳入研究.侧颈区 38例(74枚CLNM),男性 10例,女性 28例,平均年龄(43.1±8.3)岁;中央区 14例(22枚CLNM),男性 4例,女性 10例,平均年龄(34.4±16.3)岁.两组年龄和性别无统计学差异(P>0.05).侧颈区和中央区的CLNM在消融后 1个月、3个月、6个月、12个月和 24个月体积逐渐减小且VRR逐渐增加,随访 2年内CLNM完全消失,且各随访节点两组间的CLNM体积和VRR差异均无统计学意义(P>0.05).消融时 6例有颈部疼痛(侧颈区 2例,中央区 4例),无其他轻微不良反应和严重并发症发生.随访期间 8例(15.4%)出现消融区域外的复发(侧颈区3例,中央区 5例),均成功完成二次RFA.结论 RFA对甲状腺癌全切术后颈部侧颈区和中央区的CLNM均有良好的有效性和安全性.
Outcomes and safety of ultrasound-guided radiofrequency ablation on metastatic lymph nodes in lateral and central region after thyroid carcinoma surgery
Background Comparative studies on the effectiveness of ultrasound-guided radiofrequency ablation(RFA)of cervical lymph nodes metastatic(CLNM)in the lateral and central regions of patients after thyroid cancer surgery are rare.Objective To evaluate the efficacy and complications of RFA in treating CLNM in the lateral and central cervical region after total thyroidectomy.Methods A retrospective analysis was performed on patients with CLNM in the lateral and central cervical region after total thyroidectomy treated with RFA in the Ultrasound Diagnostic Department of the First Medical Center of Chinese PLA General Hospital from January 1,2020 to January 1,2021.The volume of CLNM before and after ablation,the volume reduction rate(VRR)after ablation,and the incidence of complications during ablation and follow-up were compared between the two groups.Results A total of 52 patients with average age of(40.73±11.35)years old(14 males)with 96 CLNM were included in the study,including 38 patients(74 CLNM)in the lateral and 14 patients(22 CLNM)in the central.At 1,3,6,12,and 24 months after ablation,the volume of CLNM in the lateral and the central gradually decreased and VRR gradually increased.CLNM disappeared completely within 2 years of follow-up,and there were no statistical differences in the volume and VRR of CLNM at each follow-up time points between the two groups.There were only 6 patients with minor adverse reactions(neck pain)during ablation,2 in the lateral group and 4 in the central group.No other minor adverse reactions or major complications occurred.During follow-up,8 patients(15.4%)developed new recurrent lesions outside the ablation area(3 in the lateral area,5 in the central area),and all of them successfully completed the second RFA.Conclusion RFA has shown efficacy and safety for CLNM in the lateral and central cervical regions after total thyroidectomy.

ultrasound-guided radiofrequency ablationpost-operation of thyroid carcinomacervical lymph nodes metastasisultrasonographycomplication

孟书玉、阎琳、张艳、罗渝昆

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解放军医学院,北京 100853

解放军总医院第一医学中心超声诊断科,北京 100853

超声引导下射频消融 甲状腺癌术后 颈部转移性淋巴结 超声检查 并发症

国家自然科学基金

81901746

2024

解放军医学院学报
解放军总医院-军医进修学院

解放军医学院学报

CSTPCD
影响因子:0.811
ISSN:2095-5227
年,卷(期):2024.45(4)