摘要
目的探讨"立体定向三点一线择优穿刺法"在超声引导甲状腺结节微创组织病理活检术中的应用价值。方法总结分析2009年9月—2012年4月我科应用"立体定向三点一线择优穿刺法"完成甲状腺结节微创组织病理活检921例(共1030个结节)的临床资料。结果 921例穿刺术用时6～26分钟,平均13分钟。结节直径0.3～2.3cm,平均0.92cm。结节直径<0.5cm 165例,占17.9%。结节紧邻颈部大血管、神经、气管及食道("危险区")135例,占14.6%。921例患者活检取材,穿刺成功率为100%(921/921)。活检诊断为甲状腺癌的269例,良性病变652例。活检后行手术治疗385例,病理符合率98.4%。假阴性(甲状腺癌误诊为良性疾病)6例,假阴性率1.6%(6/385)。无假阳性。活检后患者均未出现明显不适,发生腺体表面及肌间少许渗出34例,无明显血肿形成,未经特殊处置,平均1个月后自行吸收。结论 "立体定向三点一线择优穿刺法"应用简便、准确,缩短了手术时间,同时提高了病理的检出率,降低了手术风险。提高了手术的成功率。
Objective To investigate the value of “stereotactic three-point-one-line optimal puncture”in ultrasound- guided thyroid nodule minimally invasive biopsy surgery. Methods Take clinical data of 921 cases（1030 nodules） from September 2009 to April 2002 applying“stereotactic three-point-one-line optimal puncture ” minimally invasive biopsy into analysis. Results Operation time were 6 ～26 minutes in all cases,with an average of 13 minutes. Nodule diameter ranged in 0.3 ～ 2.3 cm,with an average of 0.92 cm. In 165 cases,nodule diameter were lower than 0.5cm,aecounting for 17.9 %. In 1 35 cases, nodules tightly close to cervical vessels, nerves, trachea and esophagus （as the “danger zone”） accounting for 14.6 %. All of 921 patients accepted puncture biopsy with success rate of 100 % （921/921）. Biopsy diag- nosed 269 cases of thyroid carcinoma,652 cases of benign lesions. 385 cases underwent surgical treatment after biopsy, and pathological, coincidence rate reached to 98.4 %. Six cases confirmed false negatives （thyroid cancer misdiagnosed as benign disease） ,with false-negative rate of 1.60/00 （6/385）. No false positive cases. Afte biopsies patients showed no ob vious discomfort,no obvious hematoma formation,although 34 cases occurred little effusion on the gland surface or in- termuscle without special treatment,and finally selbabsorbed within an average of one month. Conclusion “Stereotactic three-point-on-line optimal puncture” is simple, accurate, shortening the operation time. Additionally, the method im prove the pathological detection rate and success rate of surgery,and reduce the risk of surgery.
出处
《中国实验诊断学》
2013年第2期284-286,共3页
Chinese Journal of Laboratory Diagnosis
关键词
立体定向
三点一线择优穿刺法
甲状腺结节
活检
stereotactic
three-point one-line optimal puncture
thyroid nodule
biopsy
