细针穿刺技术对腔镜甲状腺手术的影响  

Effect of fine needle aspiration technique on laparoscopic thyroid surgery

作　　者：苏婷婷 徐元兵 潘代 沈浩元[1] 高银华 钱芳 邹园园 胡超华[1] SU Ting-ting;XU Yuan-bing;PAN Dai;SHEN Hao-yuan;GAO Yin-hua;QIAN Fang;ZOU Yuan-yuan;HU Chaohua(Xiaogan Hospital Affiliated to Wuhan University of Science and Technology,Xiaogan Hubei 432100,China;Medical College,School of Medicine of Wuhan University of Science and Technology,Wuhan Hubei 430070,China;Graduate School of Jinzhou Medical University,Jinzhou Liaoning 121000,China)

机构地区：[1]武汉科技大学附属孝感医院,湖北孝感432100 [2]武汉科技大学医学部医学院,湖北武汉430070 [3]锦州医科大学研究生院,辽宁锦州121000

出　　处：《局解手术学杂志》2025年第3期236-240,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨甲状腺结节在超声引导下细针穿刺活检(US-FNAB)后局部组织病理学变化对腔镜甲状腺手术的影响。方法回顾性分析武汉科技大学附属孝感医院2020年1月至2022年12月收治的120例甲状腺恶性肿瘤患者的临床资料,按照术前否是行US-FNAB分为观察组(行US-FNAB)和对照组(未行US-FNAB),每组60例。比较2组患者手术时间、手术前后甲状旁腺激素变化(ΔPTH)、手术前后血清Ca^(2+)浓度变化(血清ΔCa^(2+))、术后24 h引流量及并发症发生率。根据甲状腺结节穿刺至手术的时间间隔(FTS)进一步将观察组患者分为A组(FTS≤3 d)和B组(FTS>3 d),结合2组患者的甲状腺穿刺被膜病理学改变特点,探讨US-FNAB对腔镜甲状腺手术的影响。结果观察组患者手术时间长于对照组(P<0.05);2组患者术后24 h引流量、ΔPTH、血清ΔCa^(2+)及颜面部或肢体麻木、甲状旁腺功能减退、喉返神经完整性、低钙血症比例比较,差异均无统计学意义(P>0.05)。A、B组患者的手术时间、ΔPTH、血清ΔCa^(2+)、术后24 h引流量、术后低钙血症、喉返神经完整性和甲状旁腺功能减退比较,差异无统计学意义(P>0.05);A组术后发生颜面部或肢体麻木的患者比例显著低于B组(P<0.05)。结论术前进行甲状腺结节US-FNAB可能会延长腔镜甲状腺患者的手术时间,而在穿刺早期进行手术治疗有助于减少这种影响,并降低术后低钙血症及甲状旁腺功能减退的发生率。Objective To investigate the effect of local histopathological changes of thyroid nodules after ultrasound-guided fine needle aspiration biopsy(US-FNBA)on laparoscopic thyroid surgery.Methods The clinical data of 120 patients with thyroid malignant tumors admitted to Xiaogan Hospital of Wuhan University of Science and Technology from January 2020 to December 2022 were retrospectively analyzed,and according to whether received US-FNAB before surgery they were divided into the observation group(with US-FNAB)and the control group(without US-FNAB),with 60 cases in each group.The operation time,change of parathyroid hormone(ΔPTH)before and after surgery,change of serum Ca^(2+)concentration(serumΔCa^(2+))before and after surgery,drainage volume 24 hours after surgery and incidence of complications were compared between the two groups.According to fine needle aspiration-to-surgery(FTS),the patients in the observation group were further divided into the group A(FTS≤3 days)and the group B(FTS>3 days),and the effect of US-FNAB on laparoscopic thyroid surgery was explored combined with the pathological changes of the thyroid puncture capsule of the two groups.Results The operation time of the observation group was longer than that of the control group(P<0.05),and there was no significant difference in the drainage volume 24 hours after surgery,ΔPTH,serumΔCa^(2+),or proportions of facial or limb numbness,hypoparathyroidism,recurrent laryngeal nerve integrity,and hypocalcemia between the two groups(P>0.05).There was no significant difference in the operation time,ΔPTH,serumΔCa^(2+),drainage volume 24 hours after surgery,hypocalcemia,recurrent laryngeal nerve integrity or hypothyroidism between the group A and group B(P>0.05).The proportion of patients with facial or limb numbness after surgery in the group A was significantly lower than that in the group B(P<0.05).Conclusion Preoperative US-FNAB for thyroid nodules may prolong the operation time in patients undergoing laparoscopic thyroid surgery,and surgical treatmen

关 键 词：甲状腺结节 细针穿刺活检 超声 并发症 腔镜手术 

分 类 号：R619[医药卫生—外科学]