超声引导下细针穿刺活检在甲状腺结节不同中医证型中的应用研究

Study on Application of Ultrasound-Guided Fine Needle Aspiration in Different Chinese Medicine Syndrome Types of Thyroid Nodule

目的:探讨超声引导下细针穿刺抽吸活检术(US-FNA)在甲状腺结节中医不同证型中的临床应用。方法:对2019年1月—2020年6月行US-FNA的178例甲状腺结节患者的相关资料进行回顾性分析,将甲状腺结节分为气滞痰凝证、痰瘀互结证及瘀热伤阴证,对3种中医证型的超声图像特征以及穿刺病理结果进行统计学分析比较。结果:痰瘀互结组结节内部低回声、纵横比≥1、边缘形态不规则以及局灶点状强回声点的比例均明显高于气滞痰凝组和瘀热伤阴组,差异有统计学意义(P<0.05)。穿刺活检细胞学病理与术后病理结果提示痰瘀互结证患者的恶性率均较其余2组患者高。结论:US-FNA能够提高甲状腺癌的诊断准确率,且在痰瘀互结证患者中更具有临床应用价值。

Objective:To discuss the clinical application of ultrasound-guided fine needle aspiration(US-FNA) in different Chinese medicine syndrome types of thyroid nodule. Methods:A total of 178 cases of patients with thyroid nodule underwent US-FNA from January 2019 to June 2020,and their related data was retrospectively analyzed. Chinese medicine syndrome types of thyroid nodule included syndrome of qi stagnation and phlegm coagulation, syndrome of binding of phlegm and stasis,and syndrome of yin damage due to static heat. The features of ultrasonic image and pathological results of puncture were statistically analyzed and compared among the three Chinese medicine syndrome types. Results: In the group with syndrome of binding of phlegm and stasis,the proportions of internal hypoecho of nodules,the aspect ratio more than or equal to one,irregular marginal morphology,and punctate strong echo in local focus were significantly larger than those in the groups with syndrome of qi stagnation and phlegm coagulation and with syndrome of yin damage due to static heat,the difference being significant(P<0.05). It was indicated that maligant rate in the group with syndrome of binding of phlegm and stasis was higher than those in other two groups based on cytopathology of puncture biopsy of aspiration and postoperative pathological results. Conclusion:US-FNA can increase the accuracy rate of diagnosis of thyroid cancer,and has more clinical application value in patients with syndrome of binding of phlegm and stasis.