甲状腺恶性肿瘤绿色就诊通道的临床价值  

The clinical value of therapeutic greenway for thyroid malignancies

作　　者：周洁宏[1] 周洁 马步云[1] 何玉霜[1] ZHOU Jiehong;ZHOU Jie;MA Buyun;HE Yushuang(West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院超声科,四川成都610041

出　　处：《西部医学》2018年第11期1672-1674,共3页Medical Journal of West China

基　　金：四川省科技厅科技支撑计划项目(2015SZ0159)

摘　　要：目的探讨甲状腺恶性肿瘤绿色就诊通道的临床价值。方法选取2016年1月~2016年12月的甲状腺结节患者进行超声筛查,将TI-RADS分级为3B级及以上的509例患者纳入绿色就诊通道,进行超声专科评估和超声引导下细针抽吸活检(FNAB),采用Bethesda细胞病理报告系统(TBSRTC)进行细胞学诊断,并与同期非绿色就诊通道患者507例进行对比研究。结果 509例绿色就诊通道患者经过超声专科评估后,8例(1.6%)患者选择随访观察,501例(98.4%)患者进行FNAB,绿色就诊通道患者接受穿刺的平均时间为3d(非绿色就诊通道患者为35d)。绿色就诊通道和非绿色就诊通道的TBSRTC结果分别为Ⅰ类(11例,2.1%;81例,15.9%),Ⅱ类(25例,5.0%;96例,18.9%),Ⅲ类(58例,11%;84例,16.6%),Ⅳ类(8例,1.6%;19例,3.7%),Ⅴ类(39例,7.7%;45例,8.9%)和Ⅵ类(360例,71%;182例,35.7%)。两组患者的无效率、不能诊断率、良性率和恶性率的差异均有统计学意义(P<0.01)。结论甲状腺恶性肿瘤绿色就诊通道的建立,缩短了患者就诊时间,降低了穿刺的无效率、不能诊断率和良性率,提高了穿刺的恶性率,具有重要的临床价值。Objective To discuss the clinical value of thyroid malignancies therapeutic greenway.Methods From Jan.2016 to Sep.2016 of West China Hospital,509 patients whose TI-RADs classifications were higher than 3B were included.Bethesda system was usded for reporting thyroid Cytopathology(TBSRTC)for cytologic diagnosis Results 509 greenway patients underwent specific thyroid ultrasound examination,501 patients(501/509,98.4%)underwent FNAB and 8(8/509,1.6%)were followed up.The average wait FNAB time was 3 days of greenway patients.However non-greenway patients needed wait 35 days on average.The TBSRTC results were I type(11 cases,2.1%;81 cases,15.9%),Ⅱtype(25 cases,5.0%;96 cases,18.9%),Ⅲtype(58 cases,11%;84 cases,16.6%),Ⅳtype(8 cases,1.6%;19 cases,3.7%),Ⅴtype(39 cases,7.7%;45 cases,8.9%)和Ⅵtype(360 cases,71%;182 cases,35.7%)of greenway and non-greenway patients respectively.Difference of invalid rate,non diagnostic rate,benign and malignant rate between the two groups was significant(P<0.01).Conclusion Greenway for patients with thyroid carcinomas can not only reduce waiting time,but also decrease invalid rate,non diagnostic rate,and benign rate of aspiration biopsy.

关 键 词：超声 甲状腺 恶性肿瘤 绿色就诊通道 

分 类 号：R736.1[医药卫生—肿瘤]