| 李丹,徐华军,陈文显,韩运生,刘进.不同负压抽吸在甲状腺结节细针穿刺中的应用[J].浙江中西医结合杂志,2018,28(5): |
| 不同负压抽吸在甲状腺结节细针穿刺中的应用 |
| The application of different negativeSpressure aspiration in the fine needle aspiration biopsy of thyroid nodule |
| 投稿时间：2017-07-20 修订日期：2018-03-22 |
| DOI： |
| 中文关键词: 甲状腺结节 细针穿刺 Adler血流分级 不同负压 细胞学检查 |
| 英文关键词:Thyroid nodule Fine needle aspiration Adler grade of blood flow Different negative pressure Cytology |
| 基金项目:浙江省湖州市科技计划项目(2016GYB34) |
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| 中文摘要: |
| 目的 探讨不同负压抽吸在甲状腺结节细针穿刺中的应用价值。 方法 195个甲状腺结节随机分配入实验组和对照组进行细针穿刺,实验组细针穿刺时依据Adler血流分级选择不同强度负压抽吸,对照组则固定负压抽吸,穿刺所得标本涂片均95%无水酒精固定,送病理科进行HE染色、读片,比较两组穿刺成功率及细胞学诊断结果。结果 实验组细针穿刺成功率(95.1%)高于对照组(87.1%),不能诊断的细胞学诊断结果实验组5例(4.9%)低于对照组12例(12.9%),无明确意义的细胞学诊断结果实验组28例(27.5%)低于对照组35例(37.6%),有确定意义的细胞学诊断结果实验组68例(66.7%)高于对照组48例(51.6%),差异有统计学意义(x2=6.3,P=0.044)；实验组和对照组在鉴别甲状腺结节良恶性的敏感性93.3%比75.0%,特异性90.7%比75.7%,阳性预测值87.5%比72.7%,阴性预测值95.1%比77.8%,准确率91.8%比75.4%；阳性预测值在实验组与对照组差别无明显统计学意义(P=0.08),而敏感性、特异性、阴性预测值及准确率上实验组均优于对照组,差异有统计学意义(P﹤0.05)。结论 不同负压穿刺抽吸能提高甲状腺结节细针穿刺成功率及细胞学诊断结果。 |
| 英文摘要: |
| Objective The aim of this study was to explore the value of different negative pressure aspiration in the fine needle aspiration biopsy of thyroid nodule. Methods 195 thyroid nodules were assigned into the experimental group and the control group randomly, and treated with different methods. Different negative pressure aspiration was applied based on the Adler blood flow grading system in the fine needle aspiration biopsy in the experimental group；while in the control group, constant pressure aspiration was applied in the fine needle aspiration biopsy,the efficacy of fine needle aspiration and the results of cytology were compared. Results: The efficacy of fine needle aspiration between the experimental group and the controls were: 95.1% vs 87.1%(P﹤0.05)；the results of cytology between the experimental group and the controls were：5(4.9%)vs 12(12.9%) for unsatisfactory samples,28(27.5%)vs 35(37.6%)for atypical cell of undetermined significance without clear diagnose results,68(66.7%)vs 48(51.6%)for determined significance with clear diagnose results(x2=6.3,P=0.044). The sensitivity,specificity,negative predictive value,and accuracy of 142 surgically confirmed nodules were：93.3% vs 75.0%,90.7% vs 75.7%, 95.1% vs 77.8%,91.8% vs 75.4% for the experimental group and the controls(P﹤0.05), there was no statistically significant difference in the positive predictive value(87.5% vs 72.7%,P﹥0.05).Conclusion The application of different pressure aspiration can improve the efficacy of fine needle aspiration and the results of cytology. |
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