外科理论与实践2025，Vol.30Issue(4)：345-350,6.DOI:10.16139/j.1007-9610.2025.04.09
改良隔离液在甲状腺良性结节微波消融术中应用的安全性及有效性观察
Observation on safety and effectiveness of modified hydrodissection fluid in microwave ablation of benign thyroid nodules
摘要
Abstract
Objective To investigate the safety and effectiveness of normal saline as a hydrodissection band versus sodium hyaluronate and biopolysaccharide mixture as a modified hydrodissection band in microwave ablation(MWA)for benign thyroid nodules.Methods A total of 196 patients with 245 benign thyroid nodules(maximum diameter≥20 mm)treated at Shanghai Ruijin Rehabilitation Hospital from August 2018 to February 2022 were enrolled.Patients were divided into control group(n=114):MWA using normal saline as the hydrodissection fluid;modified group(n=131):MWA using sodium hyaluronate and biopolysaccharide mixture as the hydrodissection fluid.A hydrodissection band(about 10 mm wide)was established before MWA.Intraoperative hydrodissection fluid absorption time was recorded.At the 12-month follow-up endpoint,complications were assessed,and changes in nodule volume(volume reduction rate,VRR)were evaluated.Results The complication rate was significantly lower in the modified group(1.9%vs.14.0%,P<0.05).92.3%of complications in the control group were thermal injury-related,while no thermal injuries occurred in the modified group.Hydrodissection fluid absorption time was significantly prolonged in the modified group[(15.2±1.6)min vs.(11.0±2.3)min,P<0.05].No significant difference was observed in overall treatment efficacy(nodule VVR)between two groups(95.4%vs.96.5%,P>0.05).Conclusions The sodium hyaluronate and biopolysaccharide mixture demonstrates prolonged retention time and superior thermal insulation as an hydrodissection fluid in MWA.It reduces adhesion risks and complications such as hoarseness,dysphagia,and thermal injury,thereby enhancing procedural safety and postoperative recovery.MWA is an effective treatment for benign thyroid nodules.关键词
甲状腺良性结节/微波消融/改良隔离液/并发症/玻璃酸钠-生物多糖混合液Key words
Benign thyroid nodule/Microwave ablation(MWA)/Modified hydrodissection fluid/Complication/Sodium hyaluronate and biopolysaccharide mixture分类
医药卫生引用本文复制引用
黄莉,赵艳娜,顾建华,徐文娟,柳俊,费健..改良隔离液在甲状腺良性结节微波消融术中应用的安全性及有效性观察[J].外科理论与实践,2025,30(4):345-350,6.基金项目
上海市黄浦区卫生健康系统科研项目(HLZ202207) （HLZ202207）
