| 摘要: |
| ［摘要］ 目的 观察改良超声引导下细针穿刺细胞学检查（US-FNAC）在甲状腺结节检查中的应用效果。方法 招募2023年3月至2024年7月在中部战区总医院接受US-FNAC的甲状腺结节患者330例，采用随机数字表法将其分为对照组（采用常规US-FNAC）和观察组（采用改良US-FNAC），各165例。对照组有3例因后续查见既往有甲状腺部分切除史而被排除，有2例因在入组后确诊鼻咽癌、胃肠间质瘤而被排除。最终对照组纳入160例，观察组纳入165例。对照组采用单针结节内多点穿刺非抽吸的常规US-FNAC。观察组在对照组方法的基础上进行改良：（1）双针续贯穿刺；（2）穿刺针结节内多点旋转+提拉；（3）注射器负压抽吸。比较两组细胞学检查标本满意率、疼痛情况以及检查相关不良反应发生情况。结果 观察组细胞学检查标本满意率显著高于对照组（92.12% vs 81.88%， χ2=7.578，P=0.006）。亚组分析结果显示，在年龄<60岁、结节位于下极、结节最大径<5 mm、结节最大径≥10 mm、结节微钙化和结节粗钙化分层中，观察组细胞学检查标本满意率均高于对照组，差异有统计学意义（P<0.05）。对照组疼痛情况轻于观察组，差异有统计学意义（P<0.05）。两组检查后高血压、心动过速、穿刺点出血的发生率比较差异无统计学意义（P>0.05）。结论 改良US-FNAC能显著提升甲状腺结节细胞学检查标本满意率，有较好的临床应用价值。 |
| 关键词: 甲状腺结节 超声引导下细针穿刺细胞学检查 细胞学检查 标本满意率 |
| DOI：10.3969/j.issn.1674-3806.2026.01.09 |
| 分类号:R 581.9 |
| 基金项目:湖北省中医药管理局中医药指导性项目（编号：ZY2023F048） |
|
| Observation on application effect of modified ultrasound-guided fine-needle aspiration cytology in examination of thyroid nodules |
|
ZHANG Junjie1, ZHANG Yu2, ZHENG Qiaojun3, YANG Sihan2, YUE Ling2
|
|
1.Department of Respiratory and Critical Care Medicine, Suizhou Hospital Affiliated to Hubei University of Medicine, Suizhou 441399, China; 2.Department of Endocrinology, General Hospital of Central Theater Command, Wuhan 430070, China; 3.Department of Endocrinology, the Eighth Hospital of Wuhan, Wuhan 430070, China
|
| Abstract: |
| ［Abstract］ Objective To observe the application effect of modified ultrasound-guided fine-needle aspiration cytology(US-FNAC) in examination of thyroid nodules. Methods A total of 330 patients with thyroid nodules who received US-FNAC in General Hospital of Central Theater Command from March 2023 to July 2024 were recruited. The patients were divided into control group(treated with conventional US-FNAC) and observation group(treated with modified US-FNAC) by random number table method, with 165 patients in each group. In the control group, 3 patients were excluded subsequently due to the previous history of partial thyroidectomy, and 2 patients were excluded after enrollment because they were diagnosed with nasopharyngeal carcinoma and gastrointestinal stromal tumor. Ultimately, 160 patients were included in the control group and 165 patients in the observation group. The control group was treated with non-aspiration conventional US-FNAC using a single-needle, intranodular multi-point puncture technique. The puncture method of the observation group was modified as follows on the basis of that of the control group: (1) sequential punctures using a double-needle technique; (2)fine-needle intranodular multi-site rotating and lifting; (3)syringe negative pressure aspiration. The specimen satisfaction rate of cytological examination, pain condition, and incidence of examination-related adverse reactions were compared between the two groups. Results The specimen satisfaction rate of cytological examination in the observation group was significantly higher than that in the control group(92.12% vs 81.88%, χ2=7.578, P=0.006). The results of subgroup analysis showed that the specimen satisfaction rates of cytological examination in the observation group were significantly higher than those in the control group in the following stratifications: age <60 years, nodules located in the lower pole, maximum nodule diameter <5 mm, maximum nodule diameter ≥10 mm, nodules with microcalcifications and nodules with macrocalcifications, with statistically significant differences(P<0.05). The pain condition in the control group was milder than that in the observation group, with statistically significant difference(P<0.05). There were no statistically significant differences in the incidence rates of hypertension, tachycardia and puncture site bleeding between the two groups after the examination(P>0.05). Conclusion The modified US-FNAC technique can significantly increase the specimen satisfaction rate for cytological examination of thyroid nodules, and has good clinical application value. |
| Key words: Thyroid nodules Ultrasound-guided fine-needle aspiration cytology(US-FNAC) Cytological examination Specimen satisfaction rate |
