中国医学装备2025，Vol.22Issue(5)：1-5,5.DOI:10.3969/j.issn.1672-8270.2025.05.001
基于甲状腺结节恶性风险分层的微波消融中喉返神经损伤危险因素研究
Risk factors of recurrent laryngeal nerve injury in microwave ablation for thyroid nodules:a study based on malignant risk stratification for nodule
摘要
Abstract
Objective:To investigate the independent risk factors of recurrent laryngeal nerve(RLN)injury after microwave ablation(MWA)for thyroid nodules of different malignant stratification.Methods:The medical records of 240 patients,who underwent microwave ablation for thyroid nodules in the department of ultrasound,Beijing Friendship Hospital Affiliated to Capital Medical University from September 2022 to August 2024,were retrospectively selected.All thyroid nodule cases were categorized based on the American College of Radiology Thyroid Imaging Reporting and Data System(TI-RADS)classification criteria and whether occurred RLN injury during the ablation procedure.A total of 54 patients with RLN injury and 65 patients without RLN injury,who were classified as TI-RADS 4a or higher than that,were divided into the high-risk group,and 35 patients with RLN injury and 86 patients without RLN injury,who were classified below TI-RADS 4a,were divided into the low-risk group.And then,a series of parameters included the benign and malignant nodules,the upper diameter of nodules,the left and right diameters of nodules,anteroposterior diameters of nodules,the aspect ratio(>1,≤1),overall echo,calcification,location,cystic solidity,and ablation parameters were analyzed.The risk factors of RLN injury of two groups were analyzed by using single factor and multi factor analysis.Results:There were not significant differences in the benign and malignant nodules,the upper diameters of nodules,the left and right diameters of nodules,anteroposterior diameters of nodules,the volume of nodules,overall echo,calcification,ldiametersocation,and cystic solidity between high and low-risk groups(P>0.05).In high-risk group,the distance between nodules and esophageal groove of trachea was less or equal to 2mm,and the increase of nodule volume were independent risk factors for RLN injury(OR=4.199,1.002,P<0.05),respectively.In the low-risk group,the nodule,which location was on the Zuckerkandl tubercle(Z-nodule),was risk factor that significantly increased RLN injury(OR=3.296,P<0.05).Conclusion:For nodules with differently malignant risk,the anatomical location,volume parameters and optimized ablation plan should be paid special attention before surgery,so as to reduce the risk of RLN injury.关键词
微波消融/喉返神经(RLN)/恶性风险分层Key words
Microwave ablation/Recurrent laryngeal nerve(RLN)/Malignant risk stratification分类
医药卫生引用本文复制引用
刘冬,蒲顺帆,胡明阳,王亚文,钱林学..基于甲状腺结节恶性风险分层的微波消融中喉返神经损伤危险因素研究[J].中国医学装备,2025,22(5):1-5,5.基金项目
首都卫生发展科研专项(首发2022-1-2022) Capital's Funds for Health Improvement and Research(2022-1-2022) （首发2022-1-2022）
