使用两种不同的穿刺针对甲状腺细针穿刺标本满意率的影响

Effect of two different puncture needles on the satisfaction rate of thyroid fine needle puncture specimens

目的比较使用带芯针或者空芯针对甲状腺细针穿刺细胞学检查(fine-needle aspiration cytology,FNAC)标本满意率的影响。方法回顾性收集2019年1月~2021年7月阜阳市人民医院完成的甲状腺FNAC患者1614例1773个甲状腺结节临床资料,根据穿刺时使用针具不同分成空芯针组(n=837)和带芯针组(n=936),主要指标为标本满意率,次要指标为恶性诊断率及标本不满意原因。结果两种针标本满意率比较,空芯针组标本满意率高于带芯针组(χ^(2)=16.456,P<0.05)。标本不满意原因分析,带芯针标本中“血液污染遮蔽滤泡细胞”及“滤泡细胞少于最少诊断需要”原因高于空芯针(χ^(2)=7.476、20.298,P<0.05)。两种针标本恶性诊断率比较差异无统计学意义(χ^(2)=1.861,P>0.05)。结论对于经验丰富的穿刺操作者,使用带芯针无法提升标本满意率,同时显著增加患者的穿刺费用。

Objective The aim of the study was to compare the influence of two different puncture needles on the satisfaction rate of specimens in fine-needle aspiration cytology(FNAC)of thyroid.Methods Clinical data of 1773 thyroid nodules from 1614 patients with thyroid FNAC in Fuyang People's Hospital from January 2019 to July 2021 were retrospectively collected and divided into hollow needle group(n=837)and stylet needle group(n=936)according to different puncture needles.The primary outcome was the satisfaction rate in the samples obtained by FNAC with hollow needle or stylet needle.The secondary outcome was the diagnostic yield of malignancy and reasons of unsatisfactory specimen.Results The satisfaction rate in the samples was significantly higher in hollow needle(χ^(2)=16.456,P<0.05).Analysis of the causes of specimen dissatisfaction,specimens that obscuring blood and follicular cells are less than the minimum required for diagnosis was significantly higher in stylet needle(χ^(2)=7.476、20.298,P<0.05).There was no statistically significant difference in the diagnostic yield of malignant lesions(χ^(2)=1.861,P>0.05).Conclusion For the experienced operators,use of stylet needle does not improve the rate of satisfactory specimen,and significantly increases the FNAC costs for patients.