叶青

[摘要] 目的 探讨超声引导下细针穿刺细胞学检查诊断甲状腺小结节的临床价值。方法 以2015年1月—2017年12月该院109例甲状腺小结节患者为研究对象，全部患者均于超声引导下以细针穿刺取样进行细胞学检查，观察细胞学诊断结果。结果 109例患者超声引导细针穿刺取材均获得有效样本，无涂片不满意或无法诊断病例，样本满意度100.00%。细胞学诊断：考虑甲状腺乳头癌17例（15.60%）；可疑甲状腺乳头癌30例（27.52%）；出血组织、胶质成分、出血组织中见少量滤泡上皮29例（26.61%）；不能明确意义的细胞非典型病变33例（30.28%）。结论 以超声引导细针穿刺细胞学检查诊断甲状腺小结节，能够为甲状腺小结节临床正确处理提供有价值的参考，值得推广使用。

[关键词] 甲状腺小结节；超声；细针穿刺；细胞学检查

[中圖分类号] R44 [文献标识码] A [文章编号] 1674-0742（2018）03（c）-0182-03

Clinical Value of Fine Needle Aspiration Cytological Examination of Ultrasound-guided Thyroid Nodules

YE Qing

Department of Function， Wujin Hospital of TCM， Changzhou， Jiangsu Province， 213161 China

[Abstract] Objective To study the clinical value of fine needle aspiration cytological examination of ultrasound-guided thyroid nodules. Methods 109 cases of patients with thyroid nodules admitted and treated in our hospital from January 2015 to December 2017 were selected， all patients were for cytological examination by the fine needle aspiration samples， and the cytological diagnosis results were observed. Results The effective samples were obtained by the materials of fine needle aspiration from 109 cases of patients， and there were no cases with unsatisfactory smear， and the satisfactory rate of samples was 100.00%， and the cytological diagnosis showed that there were 17 cases with papillary thyroid cancer （15.60%）； 30 cases suspected with papillary thyroid cancer （27.52%）， 29 cases with few follicular epithelium in bleeding tissues （26.61%） and 33 cases with atypia cell lesions without definite significance （30.28%）. Conclusion The fine needle aspiration cytological examination of ultrasound-guided thyroid nodules can provide valuable reference for the clinical accurate treatment of thyroid nodules， which is worth promotion and application.

[Key words] Thyroid nodules； Ultrasound； Fine needle aspiration； Cytological examination

甲状腺结节是多种甲状腺疾病引起的甲状腺内肿块，属临床常见病症，多见于中年女性。超声是诊断甲状腺结节的有效方法，临床检出率高，但结节有良性、恶性之分，常规超声检查对实性结节的性质鉴别较为困难，特别是对于直径1 cm以下的小结节，定性准确率低，临床价值不高[1]。细针吸取细胞学检查是现阶段临床公认的非手术诊断甲状腺结节的有效方法，是帮助临床医生评估结节良恶倾向的理想手段[2]。该院近年于超声引导下对甲状腺小结节患者行细针吸取细胞学检查取得理想效果，文章现以2015年1月—2017年12月该院109例患者为例进行分析和探讨，现报道如下。……