改良法超声引导甲状腺结节细针活检的价值及其在基层医院的推广应用

Modified ultrasound-guided fine needle biopsy of thyroid nodules and its generalization in primary hospitals

目的探讨改良法超声引导甲状腺结节细针活检在基层医院推广应用的可行性及其学习曲线。方法在开展改良法超声引导甲状腺结节细针活检前,化州市人民医院派驻两名超声医师到广州医科大学附属第一医院超声科进修培训。选取2018年10月至2020年月1月化州市人民医院超声科行改良法超声引导甲状腺结节细针活检的患者77例,男性23例,女性54例,年龄为(38.9±11.1)岁,结节最大径为(13.5±4.4)mm,将病例分为3组(A、B、C组,分别为25例、25例、27例)。同时设广州医科大学附属第一医院2018年10月至2020年月1月由中级职称超声医师执行的改良法超声引导甲状腺结节细针活检的104例患者为D组,男性36例,女性68例,年龄为(38.1±12.0)岁,结节最大径为(11.6±4.7)mm。比较各组的穿刺标本合格率、操作耗时以及并发症。结果A、B、C、D组标本合格率分别为80.0%(20/25)、84.0%(21/25)、88.9%(24/27)以及88.5%(92/104),A组至C组标本合格率依次升高,但各组间穿刺标本合格率比较,差异无统计学意义(P>0.05)。A、B、C组操作用时分别为(36.9±4.6)min、(30.1±3.8)min、(27.7±3.9)min,B组与A组对比、C组与B组对比,均P<0.05。结论该改良法超声引导甲状腺结节细针活检标本合格率高、安全性高、易学快捷,适宜在基层医院推广应用。

Objective To investigate the feasibility and learning curve of ultrasound-guided fine needle biopsy of thyroid nodules in primary hospitals.Methods Two ultrasound physicians from People's Hospital of Huazhou City,a primary hospital,were assigned to the ultrasound department in First Hospital Affiliated to Guangzhou Medical University for further training before the implementation of modified ultrasound-guided fine needle biopsy of thyroid nodules.Seventy-seven patients,including 23 males and 54 females,taking modified ultrasound-guided fine needle biopsy of thyroid nodules at the department of ultrasound of People's Hospital of Huazhou City from October,2018 to January,2020 were collected;they were(38.9±11.1)years old;their maximum diameter was(13.5±4.4)mm;and they were divided into group A(25 cases),group B(25 cases),and group C(27 cases).One hundred and four patients,including 36 males and 68 females,taking modified ultrasound-guided fine needle biopsy of thyroid nodules by the intermediate professional ultrasound physicians at First Hospital Affiliated to Guangzhou Medical University during the same time period was set as group D.They were(38.1±12.0)years old and the maximum diameter was(11.6±4.7)mm.The specimen qualified rates,operation times,and complications were compared between the four groups.Results The specimen qualified rates of group A,group B,group C,and group D were 80.0%(20/25),84.0%(21/25),88.9%(24/27),and 88.5%(92/104),respectively,with no statistical difference(P>0.05).The operation times of group A,group B,and group C were(36.9±4.6)minutes,(30.1±3.8)minutes,and(27.7±3.9)minutes,respectively,with statistical differences between group A and group B and between group B and group C(both P<0.05).Conclusion Modified ultrasound-guided fine needle biopsy of thyroid nodules has a high specimen qualified rate and safety,and is easy to learn,so it is feasible to apply in primary hospitals.