目的 比较聚桂醇注射（PLI）联合微波消融（MWA）与单纯PLI治疗对于囊性或囊性为主的甲状腺结节的治疗效果。 方法 回顾分析2021年1月至2025年3月于上海交通大学医学院附属第九人民医院医院内分泌科进行PLI或PLI联合微波消融（PLI + MWA）治疗的囊性或囊性为主的甲状腺结节共90个。患者术前均进行超声评估、细针穿刺证实为良性结节。术后1、3、6个月分别接受超声评估结节大小，并计算结节缩小率（VRR）。 结果 共81例患者（90个结节）纳入分析，其中男20例（24个结节），女61例（66个结节）。共59个结节接受PLI治疗，31个结节接受PLI + MVA治疗。无论是PLI治疗还是PLI + MWA治疗，甲状腺结节均显著缩小。与PLI组相比，PLI + MWA组的结节术前体积更大［（12.12 ± 11.03）mL vs.（17.27 ± 10.49）mL，P = 0.033］，但治疗后1、3、6个月，两组结节的体积均差异无统计学意义［（4.02 ± 7.95）mL vs. （7.47 ± 6.93）mL， （2.98 ± 6.31）mL vs. （2.43 ± 2.62）mL，（3.64 ± 8.82）mL vs. （1.09 ± 2.10）mL， P > 0.05］，PLI + MWA组治疗后结节体积较基线体积的减少量在治疗3个月［（14.77 ± 8.48）mL vs. （8.36 ± 9.24）mL，P = 0.025］、6个月［（14.53 ± 6.86）mL vs. （4.79 ± 3.99）mL，P = 0.001］时，均显著大于单纯PLI治疗组。在术后1个月时PLI组的VRR高于PLI + MWA组［83.44%（66.97%，93.07%）vs. 52.53%（17.62%，90.66%），P = 0.011］，但到术后6个月时PLI + MWA组的VRR显著高于PLI组［98.62%（93.95%，99.33%） vs.81.68%（58.43%，96.96%），P = 0.019］，并且术后6个月PLI + MWA组的治愈率（VRR > 90%）（33.3% vs. 83.3%，P = 0.020）显著高于PLI组。 结论 超声引导下PLI治疗和PLI + MWA治疗对于囊性或囊性为主的良性甲状腺结节均具有较好的疗效。在术后6个月时PLI + MWA治疗较单用PLI治疗的治愈率更高。

Objective Comparison of the treatment efficacy between percutaneous lauromacrogol injection （PLI） combined with microwave ablation （MWA） and PLI alone for cystic or predominantly cystic thyroid nodules. Methods This study retrospectively analyzed 90 cystic or predominantly cystic thyroid nodules that were treated with either PLI or PLI+MWA at Shanghai Ninth People's Hospital from January 2021 to March 2025. All cases were confirmed to be benign through preoperative ultrasound and fine-needle aspiration. The size of the nodules was assessed by ultrasound at 1， 3， and 6 months after treatment， and the volume reduction rate （VRR） was calculated. Results A total of 81 patients （90 nodules） were incorporated into the analysis， including 20 males （24 nodules） and 61 females （66 nodules）. Among these nodules， 59 received PLI treatment， whereas 31 underwent PLI + MWA. Both PLI and PLI + MWA treatments led to a significant reduction in the volume of thyroid nodules. Although the baseline nodule volumes in the PLI + MWA group were larger than those in the PLI group ［（17.27 ± 10.49） mL vs. （12.12 ± 11.03） mL， P = 0.033］， there were no significant differences in nodule volumes between the two groups at 1， 3， and 6 months after treatment ［（4.02 ± 7.95） mL vs. （7.47 ± 6.93） mL； （2.98 ± 6.31） mL vs. （2.43 ± 2.62） mL； （3.64 ± 8.82） mL vs. （1.09 ± 2.10） mL； all P > 0.05］. Furthermore， at the 3-month ［（14.77 ± 8.48） mL vs. （8.36 ± 9.24） mL， P = 0.025］ and 6-month ［（14.53 ± 6.86） mL vs. （4.79 ± 3.99） mL， P = 0.001］ follow-ups， the PLI + MWA treatment group showed a significantly greater reduction in nodule volume from the baseline compared to the PLI-only group. One month after treatment， the VRR in the PLI group was higher than that in the PLI + MWA group ［83.44% （66.97%， 93.07%） vs. 52.53% （17.62%， 90.66%）， P = 0.011］. However， six months after the operation， the VRR in the PLI + MWA group was significantly higher than that in the PLI group ［83.44% （66.97%， 93.07%） vs. 81.68% （58.43%， 96.96%）， P = 0.019］. Moreover， six months after treatment， the cure rate （VRR > 90%） in the PLI + MWA group was significantly higher than that in the PLI group （87.5% vs. 33.3%， P = 0.024）. Conclusions Both ultrasound-guided PLI and PLI + MWA are effective therapeutic modalities for benign thyroid nodules with cystic or predominantly cystic components. Significantly， at 6 months after treatment， PLI + MWA yielded notably superior therapeutic outcomes compared to PLI monotherapy.