文章摘要

Meta分析超声引导下经皮微波消融术与甲状腺切除术治疗甲状腺乳头状微小癌的效果

作者: 1杨 子瑶, 1段 克南, 1秦 龙, 1熊 建霞, 1张 海涛, 2刘 静
1 山西医科大学第一临床医学院,太原 030001
2 山西医科大学第一医院普通外科,太原 030001
通讯: 刘 静 Email: liujing5585@163.com
DOI: 10.3978/j.issn.2095-6959.2019.09.023

摘要

目的:系统评估超声引导下经皮微波消融术与甲状腺切除术治疗甲状腺乳头状微小癌(papillary thyroid microcarcinomas,PTMCs)的疗效。方法:从PubMed,Google Scholar,Cochrane Library,万方,CNKI等各大数据库中检索2015至2018年的超声引导下经皮微波消融术或甲状腺切除术治疗PTMCs的临床研究,对符合标准的4篇文献进行Meta分析。结果:经过数据提取及统计学分析,与手术组相比,PMWA组住院时间短、术中出血量少、手术时间短,差别均有统计学意义。术后并发症对比结果显示,消融组术后短暂性喉返神经麻痹、短暂性手足麻木发生率低于手术组,差别有统计学意义。两组永久性并发症发生率无显著差异。术前术后甲状腺相关激素Meta分析结果显示PMWA术对于甲状腺功能影响较小。研究中包括的所有患者均未发生复发、淋巴结转移。结论:对于诊断明确,分层清晰的低风险PTCs患者,可选择PMWA术。对于术前诊断不明确、无法判断淋巴结转移情况的中、高危患者,手术治疗是最佳选择。
关键词: 微波消融术;甲状腺切除术;甲状腺乳头状癌;并发症

Meta-analysis of the curative effect of ultrasound-guided percutaneous microwave ablation and thyroidectomy on the treatment of patients with papillary thyroid microcarcinoma

Authors: 1YANG Ziyao, 1DUAN Kenan, 1QIN Long, 1XIONG Jianxia, 1ZHANG Haitao, 2LIU Jing
1 First Clinical Medical College, Shanxi medical university, Taiyuan 030001, China
2 Department of General Surgery, First Hospital of Shanxi Medical University, Taiyuan 030001, China

CorrespondingAuthor:LIU Jing Email: liujing5585@163.com

Abstract

Objective: To systematically evaluate the efficacy of ultrasound-guided percutaneous microwave ablation and thyroidectomy in the treatment of papillary thyroid microcarcinoma. Methods: The PubMed, Google scholar, Cochrane Library, Wanfang, CNKI databases were searched, and the clinical studies on ultrasound-guided percutaneous microwave ablation or thyroidectomy for the treatment of papillary thyroid micro- carcinoma were selected. The search time was from 2015 to2018, and Meta-analysis was performed on 4 articles that met the inclusion criteria. Results: After data extraction and statistical analysis, compared with the operation group, the microwave ablation group had shorter hospitalization time, less intra-operative blood loss and shorter operation time, and the differences were statistically significant. The comparison of postoperative complications showed that the incidence of transient recurrent laryngeal nerve palsy and transient hand and foot numbness in the ablation group was lower than that in the operation group, and the difference was statistically significant. There was no significant difference in the incidence of permanent complications between the two groups. Preoperative and postoperative thyroid hormone Meta-analysis results showed that microwave ablation had little effect on thyroid function. None of the patients included in the studies had recurrence or lymph node metastasis. Conclusion: Microwave ablation is an option for low-risk PTCs patients with definite diagnosis and clear stratification. Surgical treatment is the best choice for middle and high-risk patients with unclear preoperative diagnosis and inability to judge lymph node metastasis.
Keywords: microwave ablation; thyroidectomy; papillary thyroid carcinoma; complications