多方法联合检查穿刺液在腋窝囊实性肿块诊断中的应用  

Application of multiple methods in puncture fluid examination for diagnosis of axillary cystic/solid mass

作　　者：张文智[1] 杨高怡[1] 裴宇[2] 徐建平[1] 

机构地区：[1]杭州市红十字会医院超声科,310003 [2]杭州市第三人民医院儿科,310009

出　　处：《中华全科医师杂志》2016年第10期792-794,共3页Chinese Journal of General Practitioners

基　　金：杭州市医药卫生科技计划项目（2013A39）

摘　　要：为探讨穿刺液X－pert检查、穿刺细胞学病理检查及普通细菌培养联合检查在腋窝囊实性肿块诊断中的应用价值，随机选取2010年3月23日至2015年10月29日杭州市红十字会医院及杭州市第三人民医院的腋窝囊实性肿块91例患者为研究对象，依据历史对照法分为对照组（44例）和研究组（47例）。对照组行穿刺细胞学病理检查及穿刺液普通细菌培养，研究组行穿刺液X－pert检查、穿刺细胞学病理检查及穿刺液普通细菌培养等方法联合检查，以手术病理诊断结果为金标准，对两组的检查结果及诊断阳性率进行回顾性分析。结果显示，对照组、研究组患者腋窝肿块类型包括结核性脓肿、其他脓肿、转移癌、表皮样囊肿、淋巴水囊瘤。对照组、研究组所有患者诊断阳性率分别为68．2％（30／44）和93．6％（44／47），研究组较对照组高（P＝0．002）。其中，研究组结核性脓肿诊断阳性率高于对照组[100．0％（28／28）比57．7％（15／26），P＝0．000]；两组表皮样囊肿（5／5比3／3）、转移癌（3／4比3／5）、其他脓肿（7／7比8／9）、淋巴水囊瘤（1／3比3／3）的诊断阳性率差异均无统计学意义（均P＞0．05）。 X－pert检查、穿刺细胞学病理检查及普通细菌培养联合检查穿刺液诊断腋窝囊实性肿块阳性率高，在腋窝囊实性肿块诊断中具有临床应用价值。The clinical data of 91 patients with axillary cystic/solid mass receiving ultrasound-guided mass puncture in Hangzhou Red Cross Hospital and Hangzhou Third Hospital from March 2010 to October 2015 were retrospectively analyzed.The biopsy cytology examination and routain bacteria culture of puncture fluid were applied in 44 cases （ control group）; while X-pert examination of puncture fluid was performed in addition to biopsy cytology examination and routain bacteria culture in 47 cases （ study group） . The histopathological examination of surgical specimens were used as gold standard.The overall diagnostic accuracy rates of study and control groups were 93.6% （44/47） and 68.2% （30/44）, respectively（P=0.002） .The diagnostic accuracy rates for tuberculous abscess in study and control groups were 100.0%（28/28）and 57.7%（15/26）, respectively （P=0.000）.However, there were no significant differences in diagnosis of other diseases, including metastatic carcinoma, abscess other than tuberculous and lymphatic hygroma between two groups.The study shows that diagnostic accuracy of multiple examination methods of puncture fluid for axillary cystic/solid mass is high and has clinical application value.

关 键 词：活组织检查 针吸 X-pert检查 囊实性肿块 

分 类 号：R446.8[医药卫生—诊断学]