标题：超声引导下聚桂醇硬化治疗甲状腺囊肿的疗效和安全性研究

      作者：王建伟，李庆，周晓东，韩增辉，陈姗姗    西安国际医学中心医院超声诊疗中心，陕西 西安 710000

      卷次： 2023年34卷7期

      【摘要】 目的 探究超声引导下聚桂醇硬化治疗甲状腺囊肿患者的临床疗效与安全性。方法 选取2019年10月至2021年4月西安国际医学中心医院收治的90例甲状腺囊肿患者为研究对象，按随机数表法分为观察组和对照组各 45例，观察组患者进行超声引导下聚桂醇硬化治疗，对照组患者进行超声引导下无水乙醇治疗。治疗后 3个月、6个月及12个月，分别比较两组患者的临床疗效、囊腔体积及囊肿缩小率；治疗前和治疗后6个月，分别比较两组患者的游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)及促甲状腺素(TSH)水平；同时比较两组患者治疗后的不良反应发生情况。结果 治疗后3个月、6个月及 12个月，观察组与对照组患者的临床疗效分别为 93.33%与 91.11%、97.78%与 93.33%、97.78%与95.56%，差异均无统计学意义(P>0.05)；治疗6个月后，观察组与对照组患者的FT3水平分别为(3.82±0.70) pmol/L与(3.96±0.77) pmol/L，FT4水平分别为(10.68±2.73) pmol/L与(11.04±2.91) pmol/L，TSH水平分别为(2.68±0.63) mU/L与(2.55±0.58) mU/L，差异均无统计学意义(P>0.05)；治疗后，随着时间推移，两组患者的囊腔体积均减小，囊肿缩小率均升高，差异均有统计学意义(P<0.05)，但观察组与对照组患者治疗3个月、6个月及12个月时，囊腔体积和囊肿缩小率比较，差异均无统计学意义(P>0.05)；观察组患者治疗后的总不良反应发生率为8.89%，明显低于对照组的24.44%，差异有统计学意义(P<0.05)。结论 选择超声引导下聚桂醇硬化注射与无水乙醇硬化注射治疗甲状腺囊肿的治疗效果相当，但聚桂醇不容易引起不良反应，具有更高的安全性。
      【关键词】 甲状腺囊肿；聚桂醇；硬化治疗；无水乙醇；甲状腺功能；疗效；安全性
      【中图分类号】 R581.3 【文献标识码】 A 【文章编号】 1003—6350（2023）07—1002—06

Efficacy and safety of ultrasound-guided lauromacrogol sclerotherapy in the treatment of thyroid cyst.
WANGJian-wei, LI Qing, ZHOU Xiao-dong, HAN Zeng-hui, CHEN Shan-shan. Ultrasonic Diagnosis and Treatment Center,Xi'an International Medical Center Hospital, Xi'an 710000, Shaanxi, CHINA
【Abstract】 Objective To explore the clinical efficacy and safety of ultrasound-guided lauromacrogol sclero-therapy in the treatment of patients with thyroid cyst. Methods Ninety patients with thyroid cyst who were treated inXi'an International Medical Center Hospital between October 2019 and April 2021 were selected and divided into the ob-servation group and the control group by the random number table method, with 45 patients in each group. The patientsin the observation group were treated with lauromacrogol sclerotherapy under ultrasound guidance, while the patients inthe control group were treated with absolute ethyl alcohol under ultrasound guidance. The clinical efficacy, cystic cavityvolume, and cyst shrinkage rate at 3 months, 6 months, and 12 months after treatment, levels of free triiodothyronine(FT3), free tetraiodothyronine (FT4) and thyroid stimulating hormone (TSH) before treatment and at 6 months aftertreatment, and occurrence of adverse reactions after treatment were compared between the two groups. Results Therewas no statistically significant difference in the clinical efficacy between the observation group and the control groupat 3 months, 6 months, and 12 months after treatment (93.33% vs 91.11%, 97.78% vs 93.33%, 97.78% vs 95.56%, P>0.05). At 6 months after treatment, there were no statistically significant differences in the levels of FT3, FT4, and TSHbetween the two groups (P>0.05): FT3, (3.82 ±0.70) pmol/L vs (3.96± 0.77) pmol/L; FT4, (10.68 ±2.73) pmol/L vs(11.04±2.91) pmol/L; TSH, (2.68±0.63) mU/L vs (2.55±0.58) mU/L]. As time went on, the cystic cavity volume in thetwo groups was reduced after treatment, and the cyst shrinkage rate was increased, with statistically significant dif-ference (P<0.05); but the differences in the cystic cavity volume and cyst shrinkage rate at 3 months, 6 months, and12 months after treatment were not statistically significant between the observation group and the control group (P>0.05). The total incidence rate of adverse reactions after treatment was 8.89% in the observation group, which was signif-icantly lower than 24.44% in the control group (P<0.05). Conclusion Ultrasound-guided lauromacrogol sclerotherapyand absolute ethyl alcohol sclerotherapy have equivalent therapeutic effects in the treatment of thyroid cyst, but lauro-macrogol is less likely to cause adverse reactions and has higher safety.
      【Key words】 Thyroid cyst; Lauromacrogol; Sclerotherapy; Absolute ethyl alcohol; Thyroid function; Efficacy;Safety