目的:采用超声引导经皮激光消融治疗甲状腺微小乳头状癌。方法 :研究对象为2013年11月至2016年6月我院61例甲状腺微小乳头状癌病人,均为单侧病灶,行超声引导经皮激光消融治疗。术后采用超声造影评估消融范围。术后1、3、6、12个月及以后每6个月,超声检查随访消融灶大小变化及复发,以及术后并发症发生。每次随访均检测甲状腺功能。术后1、6及12个月行消融灶超声引导细针穿刺活检。结果:所有病人经皮激光消融治疗成功,未发生严重并发症。病灶的最大径和体积分别从术前的(4.6±1.5)mm和(41.7±41.2)mm~3缩小至(0.7±1.4)mm(P<0.05)和(1.8±6.8)mm~3(P<0.05),平均体积缩小率为94.3%。48(78.7%)个病灶完全消失,13(21.3%)个病灶呈瘢痕样改变。术后超声引导细针穿刺活检可见坏死组织及炎性细胞,未见肿瘤细胞。1例病人术后30个月发现颈部淋巴结转移,行手术治疗。结论:超声引导经皮激光消融治疗甲状腺微小乳头状癌是安全可靠和有效、局部的治疗方法。尚需长期随访,以及与其他传统疗法的对比研究。 OBJECTIVE: To use ultrasound-guided percutaneous laser ablation in the treatment of papillary thyroid carcinoma. Methods: From November 2013 to June 2016, 61 patients with thyroid papillary thyroid carcinoma in our hospital were all unilateral lesions. Percutaneous laser ablation was performed under ultrasound guidance. Postoperative ultrasound contrast assessment of ablation range. At 1, 3, 6, 12 months and every 6 months after operation, the size and recurrence of the lesion followed up by ultrasound were observed, and postoperative complications occurred. Thyroid function was measured at each follow-up. The postoperative 1, 6 and 12 months underwent ablation of fine needle aspiration biopsy. Results: All patients underwent successful percutaneous laser ablation without serious complications. The maximum diameters and volumes of lesions decreased from (4.6 ± 1.5) mm and (41.7 ± 41.2) mm ~ 3 to (0.7 ± 1.4) mm and (1.8 ± 6.8) mm ~ 3 <0.05), the average volume reduction rate was 94.3%. 48 (78.7%) lesions disappeared completely, and 13 (21.3%) lesions showed scar-like changes. Postoperative ultrasound guided fine needle aspiration biopsy showed necrotic tissue and inflammatory cells, no tumor cells. One patient was found to have cervical lymph node metastasis 30 months after operation and was treated surgically. Conclusion: Ultrasound-guided percutaneous laser ablation of papillary thyroid carcinoma is a safe, reliable and effective, local treatment. Long-term follow-up is required as well as comparative studies with other traditional therapies.