自由角度和改制后固定角度穿刺架引导下仿甲状腺细针抽吸穿刺体模实验

Phantom experiment of thyroid-like fine needle aspiration guided by free angle and modified fixed angle puncture stand

目的探讨自由角度及改制后固定角度穿刺架在甲状腺细针抽吸穿刺中的可行性及准确性。方法模拟甲状腺细针抽吸穿刺建立模型,由10位医生分别通过徒手穿刺、使用自由角度穿刺架和改制后固定角度穿刺架对体模中的目标进行穿刺,每人做三次穿刺,分别记录下每次穿刺的目标深度、穿刺时间和成功率并对以上数据作统计学分析。结果第一组(徒手穿刺)穿刺成功率76.7%,目标放置平均深度1.99cm,穿刺平均时间40.52s;第二组(自由角度穿刺架)穿刺成功率100%,目标放置平均深度2.12cm,穿刺平均时间7.75s;第三组(改制后固定角度穿刺架)穿刺成功率100%,目标放置平均深度2.22cm,穿刺平均时间3.26s。徒手穿刺的成功率小于自由角度和改制后固定角度穿刺(P<0.05),自由角度和改制后固定角度穿刺的目标深度均大于徒手穿刺(P<0.05),自由角度和改制后固定角度穿刺的目标深度无差异(P=0.18),自由角度和改制后固定角度穿刺操作时间均短于徒手穿刺操作时间(P<0.001),改制后固定角度穿刺操作时间短于自由角度操作时间(P<0.01)。结论使用自由角度和改制后固定角度穿刺架穿刺均比徒手穿刺有更高的准确性,改制后固定角度穿刺架较自由角度穿刺架穿刺效率更高,对甲状腺深部小结节穿刺更便捷可靠。

Objective To investigate the feasibility and accuracy of free angle and modified fixed angle puncture stand in thyroid fine needle aspiration puncture.Methods A model of thyroid fine needle aspiration puncture was established.Ten doctors punctured the phantom targets by bare hand puncture,free angle puncture stand and modified fixed angle puncture stand respectively.Each patient was punctured three times.The target depth,puncture time and success rate of each puncture were recorded and the above data were analyzed statistically.Results The success rate of the first group(bare-handed puncture)was 76.7%.The average depth of target placement was 1.99 cm.The average puncture time was 40.52 seconds.And the success rate of the second group(free angle puncture stand)was 100%.The average depth of target placement was 2.12 cm.The average puncture time was 7.75 seconds.And the success rate of the third group(modified fixed angle puncture stand)was 100%.The average depth of target placement was 2.22 cm.The average puncture time was 3.26 seconds.The success rate of free-hand puncture was less than that of fixed-angle puncture after modification(P<0.05).The target depth of free-angle puncture and fixed-angle puncture after modification was greater than that of Bare-hand puncture(P<0.05).There was no difference between free-angle puncture and fixed-angle puncture after modification(P=0.18).The operation time of free-angle puncture and fixed-angle puncture after modification was shorter than that of Bare-hand Pu the operation time of fixed angle puncture was shorter than that of free angle puncture(P<0.01).Conclusion Both free angle and modified fixed angle puncture stand have higher accuracy than unarmed puncture.The modified fixed angle puncture stand has higher puncture efficiency than free angle puncture stand,and it is more convenient and reliable for puncture of deep thyroid nodules.