上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

超声引导下甲状腺细胞学活检出血并发症的危险因素分析

柳怿1,2，夏建国1,2，李凤华1,2，蒋姝菲1,2   

  1. 上海交通大学 医学院 1.附属仁济医院南院超声科， 上海 201112； 2.附属仁济医院超声科， 上海 200127
  • 出版日期:2015-12-28 发布日期:2016-01-21
  • 通讯作者: 夏建国, 电子信箱: xiajianguo@renji.com。
  • 作者简介:柳怿（1973—）， 女， 主治医师， 博士; 电子信箱: liuyeeliuyee@163.com。
  • 基金资助:

    上海交通大学医学院附属仁济医院南院科研启动基金（2014QDM03）

Analysis of risk factors of bleeding complication of cytological biopsy of thyroid nodules under guidance of ultrasonography

LIU Yi1,2, XIA Jian-guo1,2, LI Feng-hua1,2, JIANG Shu-fei1,2   

  1. 1.Department of Ultrasound, Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine, Shanghai 201112, China； 2.Department of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2015-12-28 Published:2016-01-21
  • Supported by:

    Scientific Research Initial Foundation of Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine, 2014QDM03

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摘要：

目的  探讨与分析超声引导下甲状腺细胞学活检出血并发症的危险因素。方法  自2013年5月至2015年5月，对402例患者的416个甲状腺结节进行细胞学活检。评估的出血危险因素包括：操作者经验，活检针的内径，结节的大小、回声、血流、钙化及位置，患者的性别、年龄及血压。采用χ2检验、Fisher P检验、t和t’检验、多因素logistic回归分析这些危险因素与出血率之间的关系。结果  进行细胞学活检的416个结节中有23个并发出血，出血率与内径较粗的活检针、血流丰富的结节、包膜下的结节及患者收缩压增加显著相关（分别为P=0.005、P=0.001、P<0.001、P<0.001)。出血率与结节的大小、回声、钙化，操作者经验，患者的性别和年龄无显著相关性。结论  超声引导下甲状腺细胞学活检出血并发症具有相关的独立危险因素。

关键词: 甲状腺, 活检, 超声, 出血率, 危险因素

Abstract:

Objective  To explore and analyze risk factors of bleeding complication of cytological biopsy of thyroid nodules under guidance of ultrasonography. Methods  A total of 402 patients（416 thyroid nodules) underwent the cytological biopsy from May 2013 to May 2015 in our hospital. Risk factors of bleeding were experience of examiners, needle size, and size, echo, vascularity, calcification, and location of nodules, and gender, age, and blood pressure of patients. Correlations between risk factors and bleeding rate were analyzed by χ2 test, Fisher P test, t test, t’ test, and multivariate logistic regression. Results  Among 416 thyroid nodules undergoing cytological biopsy, 23 of them occurred bleeding complication. The bleeding rate significantly correlated with thicker needles (P=0.005), hypervascular nodules (P=0.001), nodules under the capsule (P<0.001), and increase of systolic blood pressure (P<0.001). The bleeding rate did not significantly correlate with size, echo, and calcification of nodules, experience of examiners, and gender and age of patients. Conclusion  The bleeding complication of cytological biopsy of thyroid nodules under guidance of ultrasonography has relevant independent risk factors.

Key words: thyroid, biopsy, ultrasonography, bleeding rate, risk factors