Objective: To investigate the efficacy and safety of percutaneous lauromacrogol injection (PLI) in treatment of cystic or predominantly cystic thyroid nodules. Methods: A total of 114 cystic thyroid nodules and 61 predominantly cystic thyroid nodules with pain or uncomfort or aesthetic complaints were offered PLI. Therapeutic success rates and side effects were evaluated. From October 2012 to December 2015,114 patients with cystic thyroid nodules and 61 with predominantly cystic thyroid nodules with pain or uncomfortable or aesthetic complaints at the outpatient clinic of the First Affiliated Hospital of Wenzhou Medical University were offered percutaneous lauromacrogol sclerotherapy. Cytological results were benign. This study was a prospective trial. Ultrasonography sound examination was performed in all patients before treatment. The baseline data of all the patients and the data of the patients examined at the follow-up of 1, 3, 6 and 12 months were analyzed. Therapeutic success rate (nodule volume reduction >50%) and safety were observed. The data of nodule volume reduction ratio and the function of thyroid were normal distribution and analyzed by Mann-Whitney test and t test. The data of nodule volume, symptoms score and cosmetic score were skewed distribution, which were indicated with median and analyzed by nonparamentic test. Results: The mean volume of the cystic thyroid nodules was reduced from 12.5 cm(3) before PLI to 0.2 cm(3) at 12 months after PLI (χ(2)=266.175, P<0.001), with a therapeutic success rate of 100%, and the mean volume of the predominantly cystic thyroid nodules was reduced from 10.5 cm(3) before PLI to 2.0 cm(3) at 12 months after PLI (χ(2)=203.122, P<0.001) with a therapeutic success rate of 93.4%(57/61). Pressure symptom score and cosmetic grade were significantly improved at 12 months after PLI in patients with cystic or predominantly cystic thyroid nodules. Pressure symptom score and cosmetic grade in patients with cystic thyroid nodules were Z=-6.126 and Z=-13.735, respectively; pressure symptom score and cosmetic grade in patients with predominantly cystic thyroid nodules were Z=-3.126 and Z=-7.212, respectively (all P<0.001) . There no significant difference in the thyroid functions before and after PLI in two groups of patients (all P>0.05) . The side effects of PLI were mild. Conclusion: PLI is a safe and effective alternative to treat benign cystic or predominantly cystic thyroid nodules.
目的： 评价在超声引导下经皮穿刺聚桂醇硬化治疗甲状腺囊性和囊实性结节的有效性和安全性。 方法： 2012年10月至2015年12月在温州医科大学附属第一医院甲状腺诊疗中心就诊的175例患者，其中114例为囊性结节，61例为囊实性结节，患者由于颈部疼痛、不适感或因结节影响美观行经皮穿刺注射聚桂醇硬化治疗，细胞病理学检查均为良性。本研究为前瞻性研究，在治疗前和治疗后第1、3、6、12个月随访，观察聚桂醇治疗甲状腺囊性结节或囊实性结节的有效性（结节体积缩小≥50%为有效）和安全性。结节体积缩小率、甲状腺功能指标经统计学分析符合正态分布，采用方差检验和t检验。结节体积、症状评分和美观评分经统计学分析符合偏态分布，以中位数表示，采用非参数秩检验。 结果： 在甲状腺囊性结节组，治疗前结节的基线体积中位数为12.5 cm(3)，治疗12个月后随访结节体积缩小到0.2 cm(3)（χ(2)=266.175，P<0.001），有效率达100%。囊实性结节组治疗前结节的基线体积中位数为10.5 cm(3)，治疗12个月后随访，体积为2.0 cm(3)（χ(2)=203.122，P<0.001），有效率为93.4%（57/61）。两组患者在聚桂醇治疗12个月随访时的症状评分和美观评分均得到明显改善，统计学结果为囊性结节组症状评分Z=-6.126，美观评分Z=-13.735；囊实性结节组症状评分Z=-3.126，美观评分Z=-7.212，差异均有统计学意义（P值均<0.001）。两组患者硬化剂治疗前后甲状腺功能差异无统计学意义（P>0.05）。硬化剂治疗的不良反应轻微，29例（16.6%）出现局部轻微疼痛，10例（5.7%）出现一过性低热。 结论： 超声引导下经皮穿刺聚桂醇硬化治疗甲状腺囊性或囊实性结节临床效果佳，不良反应少，可作为甲状腺囊肿的治疗方法之一。.
Keywords: Cystic thyroid nodules; Lauromacrogol; Predominantly cystic nodules; Sclerotherapy; Ultrasonography.