| 摘要: |
| 目的 系统评价射频消融与外科手术治疗甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)的疗效和安全性。资料与方法 计算机检索自建库至2021年11月在PubMed、Cochrane图书馆、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献数据库上公开发表的射频消融与外科手术治疗PTMC的相关文献。2名研究者严格按照纳入及排除标准独立进行文献筛选、资料提取并对纳入文献进行质量评价,采用Revman5.4进行Meta分析。结果 共纳入8篇文献,共1932例患者,其中射频消融组972例,外科手术组960例。Meta分析结果显示：射频消融组较外科手术组术后并发症少［RR=0.28,95％CI(0.12,0.63),P=0.002］,手术时间短［MD=-54.65,95％CI(-65.83,-43.46),P＜0.05］,术中失血量少［MD=-25.15,95％CI(-29.10,-21.20),P＜0.05］,术后住院时间短［MD=-2.48,95％CI(-3.00,-1.95),P＜0.05］,差异均具有统计学意义(P＜0.05)；术后复发或转移发生率与外科手术相当［RR=1.14,95％CI(0.52,2.51),P=0.74］,差异无统计学意义(P＞0.05)。结论 超声引导下射频消融较外科手术具有诸多优势,在PTMC的治疗中具有较高临床应用价值。 |
| 关键词: 射频消融 外科手术 甲状腺微小乳头状癌 系统评价 |
| DOI： |
| 投稿时间：2022-04-08修订日期：2022-08-20 |
| 基金项目: |
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| Radiofrequency ablation versus surgery for papillary thyroid microcarcinoma: a systematic review and Meta-analysis |
| YI Fuzhou,LI Ailing,JIA Juan,LIU Hui |
| (Southwest Medical University;Department of Ultrasound,the Affiliated Hospital of Southwest Medical University;China) |
| Abstract: |
| Objective To systematically evaluate the curative effect and security of radiofrequency ablation and surgery in the treatment of papillary thyroid microcarcinoma (PTMC). Materials and Methods Literatures that compared radiofrequency ablation and surgery in the treatment of PTMC from establishment to November 2021 were searched in databases including PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wan Fang, VIP and SinoMed. Two researchers independently screened out literature, extracted data in strict accordance with the inclusion and exclusion criteria and evaluated the quality of the included literatures. Revman5.4 was then used for meta-analysis. Results A total of 8 articles, involving 1932 patients were included, in which 972 cases were treated with radiofrequency ablation and 960 cases were treated with surgery. Results showed that the radiofrequency ablation group had fewer postoperative complications (RR=0.28,95％CI 0.12 to 0.63,P=0.002), less operation time (MD=-54.65,95％CI -65.83 to -43.46,P＜0.05), less blood loss in operation (MD=-25.15,95％CI -29.10 to -21.20,P＜0.05), shorter postoperative hospital stay (MD=-2.48,95％CI -3.00 to -1.95,P＜0.05). All the differences were statistically significant (P<0.05); The incidence of postoperative recurrence or metastasis in the radiofrequency ablation group was similar to that of surgery (RR=1.14，95％CI 0.52 to 2.51,P=0.74), and there was no statistically significant difference (P>0.05). Conclusion Ultrasound-guided radiofrequency ablation is superior to surgical procedures in many aspects, presenting a high clinical application value in the treatment of PTMC. |
| Key words: Radiofrequency ablation Surgery Thyroid papillary microcarcinoma Systematic review |
