超声引导下经皮微波消融治疗良性囊实性甲状腺结节疗效的影响因素分析

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摘要目的：分析超声引导下经皮微波消融治疗良性囊实性甲状腺结节疗效的影响因素。方法：选取2020年1月至2021年6月行超声引导下经皮微波消融治疗的160例良性囊实性甲状腺结节患者，并予术后定期随访。根据6个月随访时结节体积缩小率（volume reduction rate, VRR）将患者分为两组：VRR≥50％为显著有效组（122例），VRR<50％为非显著有效组（38例）。通过单因素及多因素分析评估影响甲状腺结节VRR的相关因素。结果：显著有效组与非显著有效组患者的性别、年龄、体重指数、结节边缘、结节最大径、结节形态、结节血流、结节纵横比差异均无统计学意义（P均>0.05）。非显著有效组中结节靠近危险三角、结节伴钙化及结节囊性成分比例＜50%的比例均低于显著有效组，差异有统计学意义（P均<0.05）。二分类Logistic回归分析显示结节靠近危险三角（OR=26.076，95% CI: 6.983～97.424,P<0.001）和结节的囊性成分比例＜50%（OR=18.690，95% CI: 5.412～64.605,P＜0.001）是微波消融治疗良性囊实性甲状腺结节效果的影响因素。根据Logistic回归分析，预测结节消融后疗效为非显著有效的模型为：M=-3.855+（3.261×结节靠近危险三角）+（2.928×结节的囊性成分比例＜50%），其诊断敏感性为78.9%（30/38），特异性为95.1%（116/122），准确性为91.3%（146/160）。结论：超声引导下经皮微波消融治疗良性囊实性甲状腺结节安全有效，可显著缩小结节体积。结节靠近危险三角和结节囊性成分比例＜50%会影响微波消融治疗良性囊实性甲状腺结节的效果。

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关键词 ：良性囊实性甲状腺结节, 超声引导, 微波消融, 体积缩小率, 影响因素

Abstract：［Abstract］Objective： To evaluate the influence factors of ultrasound (US)guided percutaneous microwave ablation (MWA) for benign cystic solid thyroid nodules. Methods： From January 2020 to June 2021, a total of 160 patients with benign cystic solid thyroid nodules were included. All patients underwent USguided percutaneous MWA. Each patient was followed up at the 6month after treatment. According to the nodule volume reduction rate (VRR), VRR≥ 50% was defined as significant effective group (122 cases) and VRR<50% as nonsignificant effective group (38 cases). Univariate analysis and multivariate analysis were used to evaluate the factors influencing the VRR of thyroid nodules. Results： Univariate analysis showed that features such as gender, age, body mass index (BMI), nodule size, maximum nodule diameter, nodule morphology, blood flow, and aspect ration were not significantly associated with VRR<50% (all P>0.05). For nonsignificant effective group, nodules located in the risk triangle, nodules being calcified, and proportion of cystic components＜50% were lower than those in the significant effective group (all P<0.05). Based on multivariate analysis, the features of nodule located in risk triangle（OR=26.076,95% CI: 6.983~97.424,P<0.001） and proportion of cystic components＜50%（OR=18.690,95% CI: 5.412~64.605,P＜0.001）were independent risk factors influencing the effect of MWA on benign cystic solid thyroid nodule. The logistic regression equation was established as follows: M=-3.855+(3.261×nodule located in risk triangle)+(2.928×proportion of cystic components＜50%). The associated sensitivity was 78.9% (30/38), specicity was 95.1% (116/122), accuracy was 91.3% (146/160). Conclusion：USguided percutaneous MWA is an effective and safe technique for the treatment of benign cystic solid thyroid nodules. It can significantly reduce the volume of thyroid nodules. The proximity of nodules to the risk triangle and proportion of cystic components＜50% may affect the efficacy of MWA in the treatment of benign cystic solid thyroid nodules.

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收稿日期: 2022-03-25

基金资助:［基金项目］国家自然科学基金资助项目（81901753）；蚌埠市科技创新指导类项目（20210305）

通讯作者: 孙丽萍（通讯作者），副主任医师，博士，E-ail:sunliping@126.com；李小龙（通讯作者），主治医师，博士，E-mail:15275388623@163.com

作者简介: ［作者简介］刘红艳（1978—），女，主治医师，硕士；

引用本文:

刘红艳，许永强，李小龙，等. 超声引导下经皮微波消融治疗良性囊实性甲状腺结节疗效的影响因素分析[J]. 江苏大学学报:医学版, 2022, 22(04): 277-282. LIU Hongyan1, XU Yongqiang1, LI Xiaolong2, SUN Liping1,2. Influence factors of ultrasoundguided microwave ablation for benign cystic solid thyroid nodules#br#. Journal of Jiangsu University(Medicine Edition), 2022, 22(04): 277-282.

链接本文:

http://zzs.ujs.edu.cn/xbyxb/CN/ 或 http://zzs.ujs.edu.cn/xbyxb/CN/Y2022/V22/I04/277

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