[1]谭琳,陈朝辉,曾渱越,等.超声引导下甲状腺小结节细针穿刺活检术护患配合效果分析[J].第三军医大学学报,2019,41(17):1703-1706.
 TAN Lin,CHEN Zhaohui,ZENG Hongyue,et al.Efficacy of nurse-patient cooperation in ultrasound-guided fine needle biopsy for thyroid nodules[J].J Third Mil Med Univ,2019,41(17):1703-1706.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第17期
页码:
1703-1706
栏目:
临床医学
出版日期:
2019-09-15

文章信息/Info

Title:
Efficacy of nurse-patient cooperation in ultrasound-guided fine needle biopsy for thyroid nodules
作者:
谭琳陈朝辉曾渱越唐春霖陈萍郭燕丽
400038重庆,陆军军医大学(第三军医大学)第一附属医院超声科
Author(s):
TAN Lin CHEN Zhaohui ZENG Hongyue TANG Chunlin CHEN Ping GUO Yanli

Department of Ultrasonography, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
甲状腺微/小结节 超声检查 细针穿刺活检术 护理
Keywords:
thyroid micro/small nodules ultrasonography fine needle aspiration biopsy nursing
分类号:
R581.33; R445.14; R473
文献标志码:
A
摘要:

目的探讨超声引导下细针抽吸活检术(fine-needle aspiration biopsy,FNAB)在甲状腺微/小结节中的应用价值及护患配合要点。方法选取2018年1-12月在我科进行超声引导下FNAB的甲状腺小结节(最大直径≤10.0 mm)患者1 109例,再分为小结节(最大直径>5.0~10.0 mm)与微小结节(最大直径≤5.0 mm)两组,比较两组患者FNAB取材满意率及病理诊断结果。专科护士针对性进行临床护理与心理疏导,指导患者密切配合。结果1 109例患者中甲状腺小结节718例、微小结节391例,超声引导下FNAB均获成功(2例患者检查中因吞咽动作致使穿刺针发生移位,行二次穿刺)。甲状腺小结节与微小结节组取材满意率分别为94.85%与91.30%,两组无法明确诊断者分别为5.15%与8.70%。并发症发生率1.71%(19/1 109),其中2例FNAB后见甲状腺右叶有裂隙样出血,针对性进行心理疏导与护理,1 h后复查超声,甲状腺右叶裂隙样出血停止。其余17例患者未行特殊处理而自行缓解,无严重并发症发生。结论对于甲状腺小结节,FNAB不仅可明确病变性质,且安全、有效。甲状腺微/小结节穿刺活检术的针对性护理能够提高穿刺率及病理诊断率,改善患者情绪状态,降低术后并发症的发生。

Abstract:

ObjectiveTo investigate the application value of ultrasound-guided fine needle aspiration biopsy (FNAB) for thyroid micro/small nodules and the key points of the cooperation between nurses and patients. MethodsA total of 1 109 patients with small thyroid nodules (maximum diameter≤10.0 mm) who underwent aspiration with ultrasound guidance in our department from January to December 2018 were enrolled in this study. They were divided into small nodule group (maximum diameter >5.0~10.0 mm) and micro nodule group (maximum diameter ≤5.0 mm). The satisfaction rate of aspirated tissue samples for FNAB and the pathological results were compared between the 2 group. Individually clinical care and psychological counseling were provided by specialized nurses to guide the patients to cooperate closely in the procedure. ResultsAmong the 1 109 patients, 718 patients were identified with small thyroid nodules and 391 patients with micro nodules, and all of them accepted ultrasound-guided FNAB successfully. Only 2 patients underwent a second puncture due to the puncture needle shifting because of their swallowing during the examination. Satisfaction rates of harvested samples were 94.85% in the small nodule group and 91.30%, in the micro nodule group, and the rates of undiagnosed cases were 5.15% and 8.70% in the 2 groups respectively. The incidence of complications was 1.71% (19/1 109), and 2 cases of them experienced fissure-like hemorrhage in the right lobe of the thyroid after the procedure. After targeted psychological counseling and nursing, the hemorrhage stopped in ultrasound examination in 1 h later. The other 17 patients had all symptoms alleviated though no special treatment, and no serious complications occurred. ConclusionFNAB is a safe and effective procedure to confirm the pathological changes of thyroid small nodules. Individualized nursing care can improve the success rate of the puncture and rate of pathological diagnosis, improve the emotional state of patients and reduce the incidence of postoperative complications.

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更新日期/Last Update: 2019-09-09