超声导引无水乙醇硬化治疗甲状腺囊肿疗效观察

目的观察超声导引下经皮无水乙醇硬化治疗甲状腺囊肿的疗效。方法甲状腺囊肿患者34例(共40个囊肿),在声像图的监视下将PTC针(18～20 G)经皮刺入囊肿内,按抽吸囊液量的25%注入无水乙醇,并反复抽吸2～3次,最后囊肿内保留0.5～1.0 ml硬化剂,治疗后3、6、12个月复查超声,测量囊肿大小。疗效判断标准分为4级,0级囊肿大小无变化;Ⅰ级囊腔较治疗前缩小<1/3;Ⅱ级囊腔缩小在1/3～2/3之间;Ⅲ级囊腔基本消失或完全消失。结果 34例患者40个囊肿,囊肿最大4.3 cm×5.2 cm,最小1.3 cm×1.5 cm,抽出囊液3～25 ml。术后3个月复查超声有效率85.0%,治愈率32.5%;6个月有效率90.0%,治愈率40.0%;12个月有效率100%,治愈率77.5%。5例注射乙醇时出现疼痛,10 min后消失,全部病例未出现严重并发症。结论超声导引下无水乙醇硬化治疗甲状腺囊肿简单易行、效果好、痛苦小、安全,可以替代传统手术治疗,值得临床推广应用。

Clinical observation of ultrasound-guided percutaneous ethanol sclerotherapy for thyroid cyst

Objective To observe the clinical effect of ultrasound-guided percutaneous ethanol sclerotherapy for the treatment of thyroid cyst.Methods The study was conducted in 34 patients（40 thyroid cysts）.Anhydrous ethanol in the amount of 25% of volume of cystic fluid was injected into thyroid cyst with 18~20G needle under ultrasonography guidance.After 2~3 times aspirations,0.5~1 ml of ethanol was retained.At 3,6 and 12 months after treatment cyst volumes were measured by ultrasonography.The evaluation of efficacy was based on the reduction of cyst volume after treatment;no reduction,reduction less than 1/3,reduction between 1/3~2/3 and completely disappeared cyst were classified as grade 0,Ⅰ,Ⅱ,and Ⅲ cysts respectively.Results Of the 40 cysts,the biggest was 4.3 x 5.2 cm,the smallest was 1.3 x1.5 cm;the aspirated cyst fluid was 3~25 ml.At 3 month after treatment,the effective rate was 85.0%,cure rate was 32.5%;at 6 months after treatment;effective rate was 90.0%,cure rate was 40.0%;at 12 months after treatment,effective rate was 100%,cure rate was 77.5%.Five cases complained pain when ethanol was injected,and the pain disappeared after 10 minutes.No serious complication occurred.Conclusion Ultrasound-guided percutaneous ethanol sclerotherapy for the treatment of thyroid cyst is simple,safe and effective.