Effect of ultrasound-guided interstitial laser photocoagulation on benign solitary solid cold thyroid nodules -: a randomised study
Effect of ultrasound-guided interstitial laser photocoagulation on benign solitary solid cold thyroid nodules -: a randomised study
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DOI：
10.1530/eje.1.01865
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发表时间：
2005-03-01
影响因子：
5.8
通讯作者：
Hegedüs, L
中科院分区：
文献类型：
--
作者：
Dossing, H;Bennedbaek, FN;Hegedüs, L
目的：通过在一项前瞻性随机研究中比较一次ILP治疗与未治疗，评价超声（US）引导的间质激光光凝（ILP）对良性孤立性实性冷甲状腺结节的甲状腺功能、结节大小和患者满意度的疗效。材料和方法：30例甲状腺门诊患者，均为良性孤立性实性结节和CT显示的冷甲状腺结节，引起局部不适，被分配到一个ILP疗程观察组15例，随访6个月。在随访前和随访期间，通过超声评估甲状腺结节体积和甲状腺总体积，并通过常规检测确定甲状腺功能。在视觉模拟量表上评估6个月前和6个月时的压力和美容投诉。结果：在ILP组中，结节体积在6个月后从8.2 ml（6.1：11.9）（中位数：四分位数）减少到4.8 ml（3.0：6.6）（P = 0.001）。总体中位降幅为44%（37; 52）。这与压力症状以及美容投诉的显著减少相关。在对照组中，观察到6个月后结节体积中位数增加7%（0; 34），但无显著性。ILP组未见严重副作用。热能沉积与结核体积减少之间没有相关性。甲状腺功能是unalteredthrough.Conclusion：US引导下的ILP，作为一个单一的治疗，导致在一个令人满意的临床反应，在大多数患者的良性孤立性固体冷甲状腺结节，并可能成为一个临床相关的替代手术在选定的患者。
Aim: To evaluate the efficacy of ultrasound (US)-guided interstitial laser photocoagulation (ILP) on thyroid function, nodule size and patient satisfaction in benign solitary solid cold thyroid nodules by comparing one ILP session with no treatment in a prospective randomised study.Materials and methods: Thirty cuthyroid outpatients with a benign solitary solid and a scintigraphically cold thyroid nodule causing local discomfort were assigned to one session of ILP (n = 15) or observation (it = 15) and followed for 6 months. Thyroid nodule volume and total thyroid volume were assessed by US and thyroid function was determined by routine assays before and during follow-up. Pressure and cosmetic complaints before and at 6 months were evaluated on a visual analogue scale. ILP was performed under US guidance and with an output power of 2.5-3.5 W.Results: In the ILP group, the nodule volume decreased from 8.2 ml (6.1: 11.9) (median: quartiles) to 4.8 ml (3.0: 6.6) after 6 months (P = 0.001). The overall median reduction was 44%, (37; 52). which correlated with a significant decrease in pressure symptoms as well as cosmetic complaints. In the control group, a non-significant increase in median nodule volume of 7% (0; 34) after 6 months was seen. No major side-effects were seen in the ILP group. There was no correlation between thermal energy deposition and nodule volume reduction. Thyroid function was unaltered throughout.Conclusion: US-guided ILP, given as a single treatment, resulted in a satisfactory clinical response in the majority of patients with a benign solitary solid cold thyroid nodule, and may become a clinically relevant alternative to surgery in selected patients.