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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
Efficacy of nurse-patient cooperation in ultrasound-guided fine needle biopsy for thyroid nodules
- 第三军医大学学报 2019年41卷第17期 页码：1703-1706，封三
- 作者机构：
400038 重庆，陆军军医大学(第三军医大学)第一附属医院超声科
- 作者简介：
[ 郭燕丽，E-mail:guoyanli71@aliyun.com GUO Yanli, E-mail:guoyanli71@aliyun.com
- 基金信息：
DOI：10.16016/j.1000-5404.201905048
中图分类号： R581.33;R445.14;R473收稿：2019-05-08，
修回：2019-08-02，
纸质出版：2019-09-15
- 稿件说明：
移动端阅览
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，封三.
Lin TAN, Zhaohui CHEN, Hongyue ZENG, et al. Efficacy of nurse-patient cooperation in ultrasound-guided fine needle biopsy for thyroid nodules[J]. Journal of Third Military Medical University, 2019, 41(17): 1703-1706，封三.
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，封三. DOI： 10.16016/j.1000-5404.201905048.
Lin TAN, Zhaohui CHEN, Hongyue ZENG, et al. Efficacy of nurse-patient cooperation in ultrasound-guided fine needle biopsy for thyroid nodules[J]. Journal of Third Military Medical University, 2019, 41(17): 1703-1706，封三. DOI： 10.16016/j.1000-5404.201905048.
摘要
目的
2
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
2
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
2
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
2
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
Objective
2
To 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.
Methods
2
A 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.
Results
2
Among 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.
Conclusion
2
FNAB 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.
关键词
Keywords
references
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