超声引导下微创组织活检技术在甲状腺外科的应用

目的 探讨超声引导下微创组织活检技术在甲状腺疾病诊治中的指导意义.方法 总结吉林大学中日联谊医院甲状腺外科2008年10月至2009年7月间,117例(共131个结节,结节直径大小在0.5～1.5 cm之间,平均直径约0.8 cm)甲状腺疾病患者,行超声引导微创组织活检的临床资料并进行分析.结果 117例患者,活检取材满意,行组织活检后均未出现明显不适及活检后并发症.其中59例患者活检后行手术治疗,仅有2例术前活检病理与术后石蜡病理未完全符合;未行手术治疗的58例患者,结合症状、查体、甲状腺功能和彩色多普勒超声等辅助检查,行对症治疗并定期复查,症状及彩色多普勒超声下影像均有明显好转,治疗效果良好.117例微创组织活检患者中8例同时行颈部肿大淋巴结活检,活检病理与术后石蜡病理结果一致(7例为转移癌,1例为反应性增生),准确率为100%.结论 超声引导下微创组织活检术对甲状腺疾病的诊治有重要的指导意义,临床符合率高,特别是对于微小结节的术前诊断具有较高的价值,既可避免不必要的过度治疗,又可减少甲状腺癌的漏诊,同时本技术具有简便易行、安全准确的优点,在甲状腺外科具有一定的临床应用价值.

Ultrasound-guided minimally invasive biopsy techniques in thyroid surgery

Objective To approach the guide of ultrasound-guided minimally invasive biopsy technique in diagnosis and treatment of thyroid diseases. Methods One hundred and seventeen cases (a total of 131 nodules, nodules 0. 5-1.5 cm in diameter, with an average diameter of approximately 0. 8 cm) with thyroid nodules , under Ultrasound-guided minimally invasive biopsy techniques from October 2008 to July 2009 were analyzed. Result One hundred and seventeen cases of patients with biopsy derived satisfaction were not ap-parent discomfort and complications after biopsy. Across 59 cases of surgical treatment in patients with biop-sy, and preoperative biopsy and postoperative pathologic is not fully consistent in only two cases, 58 patients without surgical treatment, who is combined with symptoms, palpation, serum thyroxine and color Doppler ultrasound and other laboratory examinations, and regularly review treated with symptomatic treatment, the symptoms, and color Doppler ultrasound imaging were much better under the treatment. 8 cases of patients in 117 cases of minimally invasive biopsy have cervical lymph node biopsy at the same time, biopsy patholo-gy and postoperative results are consistent with postoperative pathologic (7 cases of metastatic carcinoma, 1 case of reactive hyperplasia), accuracy was 100%. Conclusion Uhrasound-guided minimally invasive bi-opsy technique have important guiding for diagnosis and treatment of thyroid diseases, consistent with the high rate of clinical, especially for the preoperative diagnosis of small nodules, to avoid unnecessary over-treatment, can also reduce the misdiagnosis of thyroid cancer. While this technology is simple, safe and ac-curate, which have clinical value in the thyroid surgery.