粗针穿刺切割活检术诊断黏膜下型鼻咽肿瘤的应用探讨

Application of cut needle biopsy in the diagnosis of submucosal type of nasopharyngeal neoplasms

目的 探讨粗针穿刺切割活检诊断黏膜下型鼻咽部肿瘤的应用.方法 对17例诊断鼻咽部和（或）咽旁间隙肿物性质待查的患者进行了粗针穿刺切割活检术.记录出血量,采用疼痛数字评分法对患者疼痛程度进行评价.结果 穿刺操作出血量1～5ml,平均（1.9±0.3）ml.疼痛数字评分法评分2～7分,平均（4.0±0.4）分.所有病例中无大出血等并发症出现.17例患者均穿刺获得足够的组织用于病理诊断.17例患者中3例病理报告为慢性炎症,随访6 ～ 33个月,无异常;12例为鼻咽部未分化非角化性癌,其中鼻咽癌首诊患者5例,鼻咽癌治疗后复发7例;2例为淋巴瘤.结论 粗针穿刺切割活检诊断黏膜下型鼻咽部肿瘤具有安全、创面小、出血少、疼痛感不明显、取材满意、简单经济、诊断率高的优点.

Objective To evaluate the efficacy of cut needle biopsy in the diagnosis of submucosal nasopharyngeal neoplasms.Methods Cut needle biopsy performed with automatic biopsy gun was applied in 17 cases with submucosal type of nasopharyngeal neoplasms.The bleeding quantity was recorded and the pain was measured by score.Results Adequate biopsy sample for hispathological diagnosis was received from each of the 17 patients.And the hispathological diagnosis were consistent with the follow-up visit.The bleeding quantity ranged from 1 to 5 ml （（1.9 ± 0.3） ml）.The scores of numerical rating scale were between 2-7 （4.0 ± 0.4）.There were no serious complications such as hemorrhea.There were 3 patients of inflammation in pathological diagnosis.And These 3 patients had no tumor during the follow-up（from 6 to 33 months）.There were 12 patients of undifferentiated cancer.Among the 12 patients,there were five newly diagnosed patients and seven recurrent patients.There were 2 patients of lymphoma.Conclasion Cut needle biopsy has the advantages of minimal trauma,shorter operative time,less bleeding,light pain,and no serious complications.It is simple,safe,and worth of application clinically.