评价经皮注射脊髓灰质炎(PPI)治疗甲状腺囊性结节的疗效和安全性。
这项前瞻性研究纳入了111例患者,其中122例以甲状腺囊性结节为主的良性结节引起压力症状或美容问题。结节被随机分为一次抽吸,有(n=61)或没有(n=61)随后的PPI,并在1、3、6和12个月后进行随访。第2组10例患者(12个结节)在误吸后拒绝随访。结节体积,症状评分,治疗前后进行美容评分评价。还评估了PPI治疗主要囊性甲状腺结节的治疗成功率和安全性。
在PPI组中,结节体积从13.67±9.90减少到2.60±2.66(p<.001)。PPI组61个结节中57个(93.44%)获得治疗成功率(结节体积减少>50%),与抽吸组49人中的7人(14.29%)相比(p<.001)。在愿望小组中,结节体积没有明显减少。PPI组(从3.60±1.65到1.60±1.19)的症状评分降低明显高于误吸组(从3.62±1.89到3.30±1.06)(组间p<0.001)。化妆品评分的降低显示各组之间存在显著差异(p<.001)。总的来说,PPI组4.92%(3/61)和抽吸组85.71%(42/49)的患者在随访期间出现复发。组间复发率有显著差异(p<.001)。没有发生重大副作用。
US指导的PPI治疗良性复发性以囊性甲状腺为主的结节是有效和安全的。PPI是良性复发性占优势的甲状腺囊性结节的重要替代方法。
To evaluate the efficacy and safety of percutaneous polidocanol injection (PPI) in treatment of predominantly cystic thyroid nodules.
This prospective study included 111 patients with 122 benign predominantly cystic thyroid nodules inducing pressure symptoms or cosmetic problems. The nodules were randomized to a single aspiration with (n = 61) or without (n = 61) subsequent PPI and followed up after 1, 3, 6, and 12 months. Ten patients (12 nodules) declined to follow up after aspiration in group 2. Nodule volumes, symptoms scores, and cosmetic scores were evaluated before and after treatment. The therapeutic success rate and safety of PPI for treatment of predominantly cystic thyroid nodules were also evaluated.
In the PPI group, the nodule volumes were reduced from 13.67 ± 9.90 to 2.60 ± 2.66 (p < .001). Therapeutic success rate (nodule volume reduction >50%) was obtained in 57 of 61 (93.44%) nodules in the PPI group, compared to seven of 49 (14.29%) in the aspiration group (p < .001). In the aspiration group, the nodule volume was not significantly reduced. The reduction in symptom scores was significantly higher in the PPI group (from 3.60 ± 1.65 to 1.60 ± 1.19) than in the aspiration group (from 3.62 ± 1.89 to 3.30 ± 1.06) (p < .001, between groups). The reduction in cosmetic scores showed a significant difference between groups (p < .001). In total, 4.92% of patients (3/61) in the PPI group and 85.71% (42/49) in the aspiration group showed recurrence during the follow-up period. There was a significant difference in the recurrence rate between groups (p < .001). No major side-effects occurred.
US-guided PPI of benign recurrent predominantly cystic thyroid nodules is effective and safe. PPI is an important alternative to benign recurrent predominantly cystic thyroid nodules.