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目的总结分析甲状腺小结节激光消融效果,探讨超声引导下组织间激光消融治疗甲状腺小结节的价值。方法超声引导下对河北省第七人民医院收治的33例患者102个甲状腺小结节实施组织间激光消融治疗,分析总结治疗效果、风险、操作方法与技巧。结果一次消融成功结节95个,单次消融成功率97.06%。有3个囊实性结节产生气化迅速甚至弥散于周围组织间,影响观察及消融范围判定,行二次消融成功。单个患者消融结节个数1~10个,手术时间平均45min。术中甲状腺周围少量出血1例,局部加压后未再出血。囊性为主的囊实性结节,囊内出血2个。所有病例无中转开放手术。患者述疼痛较明显者1例,32例仅有轻微的不适可耐受。1例出现低热,次日症状消失。结论组织间激光消融甲状腺小结节疗效确切,创伤小痛苦小,对甲状腺损伤小,适用于甲状腺良性小结节的治疗。
Objective To summarize and analyze the effect of laser ablation of small thyroid nodules and investigate the value of ultrasound-guided laser ablation of small thyroid nodules. Methods Twenty-two thyroid nodules of 33 patients admitted to the Seventh People’s Hospital of Hebei Province underwent ultrasound-guided laser ablation. The effects, risks, operation methods and techniques of the treatment were analyzed and summarized. The results of a successful ablation of 95 nodules, a single ablation success rate of 97.06%. There are three cystic solid nodules produce gasification rapidly or even dispersed in the surrounding tissue, affecting the scope of observation and ablation, the line of successful ablation. A single patient ablation nodules the number of 1 to 10, the average operation time 45min. A small amount of bleeding around the thyroid surgery in 1 case, no local pressure after bleeding. Cystic solid cystic nodules, intracapsular hemorrhage 2. All cases without transit surgery. One patient reported more pain, 32 patients with only mild discomfort may be tolerated. 1 case of fever, the next day the symptoms disappear. Conclusion Intra-articular laser ablation of small thyroid nodules is effective, less trauma and less damage to the thyroid gland. It is suitable for the treatment of small benign thyroid nodules.