甲状腺结节超声引导下粗针穿刺组织学活检的安全性探讨  

Safety of ultrasound guided core needle biopsy for diagnosis of thyroid nodules

作　　者：万文博[1] 汪伟[1] 夏长虹 罗渝昆[1] WAN Wenbo;WANG Wei;XIA Changhong;LUO Yukun(Department of Ultrasound,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心超声科,北京100853

出　　处：《解放军医学院学报》2019年第3期238-242,共5页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨甲状腺结节超声引导下粗针穿刺组织学活检(ultrasound guided core needle biopsy,US-CNB)的安全性。方法回顾性分析2009年6月-2016年6月在本中心超声诊断科进行过术前超声引导下粗针穿刺的2 051例患者的2 286个结节的穿刺病历记录,分析其各类出血、神经损伤、迷走神经性晕厥、咯血、疼痛及咽部不适、针道转移等并发症的发生及转归。结果 2 286个甲状腺结节经超声引导下CNB后发生各类出血242例(10.6%),神经损伤11例(0.48%),迷走神经性晕厥16例(0.70%),咯血3例(0.13%),疼痛及咽部不适205例(8.97%),针道转移2例(0.09%),所有并发症经简单对症处理后均自行恢复正常,无危及生命或造成永久性功能障碍病例。结论超声引导下对甲状腺结节CNB的并发症少而轻,安全可靠,在甲状腺结节术前诊断应用中具有可行性。Objective To explore the safety and value of ultrasound guided core needle biopsy(CNB)for preoperative diagnosis of thyroid nodules.Methods From June 2009 to June 2016,clinical records of 2 286 thyroid nodules from 2 051 patients underwent ultrasound guided CNB in our department were retrospectively analyzed.The complications including hemorrhage,nerve injury,vasovagal syncope,hemoptysis,pain(pharyngeal discomfort)and needle track metastasis were classified and recorded.Results The incidences of hemorrhage was 10.59%(242/2 286),nerve injury 0.48%(11/2 286),vasovagal syncope 0.70%(16/2 286),hemoptysis0.13%(3/2 286),pain(pharyngeal discomfort)8.70%(205/2 286)and needle track metastasis 0.09%(2/2 286).All complications were completely managed after simple symptomatic treatments,and none of the patients suffered from serious life-threatening or permanent dysfunction.Conclusion US-CNB is a safe and reliable method for the preoperative diagnosis of thyroid nodules.

关 键 词：甲状腺 超声 粗针活检 安全性 

分 类 号：R736.1[医药卫生—肿瘤]