穿刺针及穿刺方法对样本获取量影响的实验研究

Effect of different needle sizes and aspiration techniques on sample quantity

目的探讨不同型号的穿刺针和不同穿刺方法对穿刺样本量的影响。方法3种不同型号的穿刺针（19G、22G、25c），分别采用无负压、10ml负压、20ml负压和慢提法（slow．pull）这四种不同的穿刺方法，对离体猪肝进行穿刺（每块猪肝上采用1种穿刺方法），同一穿刺方法下每种型号的穿刺针各取6份样本，病理切片行获取样本评分。结果样本平均分19G穿刺针为（5．71±0．69）分，22G穿刺针为（4．63±1．24）分，25G穿刺针为（3．79±1．84）分；无负压法为（4．72±1．53）分，10m1负压法为（4．56±1．46）分，20ml负压法为（4．72±1．50）分，慢提法为（4．83±1．76）分。多因素方差分析显示，不同型号的穿刺针对穿刺样本获取量有影响（F=12．00，P〈0．001），且19G穿刺针最优，22G穿刺针次之，25G穿刺针样本获取量最少；而穿刺方法对穿刺样本量未发现明显影响（F=0．128，P=0．943）。穿刺针和穿刺方法组合分析显示，无论采用何种方法穿刺针越粗穿刺样本量越好，19G穿刺针使用无负压吸引样本获取量最好，22G穿刺针使用20m1负压吸引样本量获取最好，25G穿刺针使用慢提法样本获取量最好。结论临床上应根据不同的穿刺针选择不同的穿刺方法。19G穿刺针获取样本量能力好，在条件允许的情况下应尽量选择19G穿刺针，并选择无负压穿刺方法；而22G穿刺针建议使用20ml负压吸引，25G穿刺针建议使用慢提法。

Objective To investigate the effect of needle sizes and aspiration techniques on sample quantity. Methods Aspiration was performed on porcine liver in vitro for 10 times with three different sizes of needles（ 19 G, 22 G and 25 G） and four different aspiration techniques [ non-negative pressure（ NP ）, 10 ml NP,20 ml NP and slow-pull] , 20 mm in depth. A total of six aspirations were performed with each needle by the same aspiration technique. All the obtained specimens were fixed in formalin with the cell block method. The samples were evacuated according to our grading criteria. Results The mean_＋ standard deviation （SD） score for 19 G,22 G, 25 G were 5.71±0. 69,4. 63±1.24, 3.79±1.84 respectively. The mean-＋SD score for methods non-NP, 10 ml NP, 20 ml NP and slow-pull were 4. 72± 1.53,4. 56± 1.46,4. 72± 1.50,4. 83 ± 1.76 respectively. The multi-analysis of variance results showed that there were statistical differences between different needles size（ F = 12. 00, P〈0. 001 ）with 19 G being the best, followed by 22 G and the least specimen obtained by 25 G needle. There were no statistical differences among aspiration techniques （ F = 0. 128, P = 0. 943）.The analysis showed that the thicker the needle was ,the better sample quality was 19 G yielded to the highest quantity of specimens.The most specimens could be obtained with 19 G needle and non-NP, 22 G needle and 20 ml NP and 25 G needle and slow-pull. Conclusion In clinic, aspiration technique should be selected according to different aspiration needles. 19 G is superior to others, with non-NP method. For 22 G needle, 20 ml NP is preferred and for 25 G needle, slow-pull is preferred.