改良液体隔离法微波消融治疗继发性甲状旁腺功能亢进

目的观察超声引导下改良液体隔离法微波消融治疗继发甲状旁腺功能亢进(SHPT)的有效性及安全性。方法回顾性分析82例接受超声引导下微波消融治疗的SHPT患者,其中41例采用改良液体隔离法(观察组),41例采用传统液体隔离法(对照组),对比2组单位体积消融时间,术前及术后7天血清全段甲状旁腺激素(iPTH)水平、iPTH变化率及钙水平,术中及术后6个月内喉返神经损伤发生率及恢复率。结果2组单位体积消融时间,术前与术后7天血清iPTH水平、iPTH变化率及钙水平差异均无统计学意义(P均>0.05)。观察组术中及术后6个月内喉返神经损伤发生率为14.63%(6/41),低于对照组(43.90%,18/41,P=0.004)。术后6个月,观察组6例(6/6,100%)喉返神经损伤患者均恢复,对照组13例(13/18,72.22%)恢复(P=0.003)。结论改良液体隔离法微波消融可有效治疗SHPT,并减少喉返神经损伤。

Safety and efficacy of modified liquid isolation method in microwave ablation in treatment of secondary hyperparathyroidism

Objective To observe the safety and efficacy of modified liquid isolation method during ultrasound-guided microwave ablation in treatment of secondary hyperparathyroidism (SHPT). Methods Clinical data of 82 SHPT patients who underwent ultrasound-guided microwave ablation were retrospectively analyzed. Among them, 41 cases adopted improved liquid isolation method (observation group), while the other 41 cases received traditional liquid isolation method (control group). Unit volume ablation time, serum intact parathyroid hormone (iPTH), iPTH change rate and serum calcium before and 7 days after operation, the incidence and recovery rate of recurrent laryngeal nerve injury during and 6 months after operation were compared between the two groups. Results There was no significant difference of unit volume ablation time, serum iPTH, iPTH change rate nor serum calcium level before and 7 days after operation between the two groups (all P>0.05). The incidence of recurrent laryngeal nerve injury in observation group during and 6 months after operation was 14.63% (6/41), lower than that of control group (43.90%[18/41], P=0.004). Six months after operation, all 6 patients (6/6, 100%) with recurrent laryngeal nerve injury in observation group and 13 patients (13/18, 72.22%) in control group recovered (P=0.003). Conclusion Modified liquid isolation microwave ablation can effectively treat SHPT and reduce recurrent laryngeal nerve injury.