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甲状腺恶性肿瘤绿色就诊通道的临床价值
周洁宏,周洁,马步云,何玉霜
0
(四川大学华西医院超声科)
摘要:
目的 探讨甲状腺恶性肿瘤绿色就诊通道的临床价值。方法 选取2016年1月~2016年12月的甲状腺结节患者进行超声筛查,将TI-RADS分级为3B级及以上的509例患者纳入绿色就诊通道,进行超声专科评估和超声引导下细针抽吸活检(FNAB),采用Bethesda细胞病理报告系统(TBSRTC)进行细胞学诊断,并与同期非绿色就诊通道患者507例进行对比研究。结果 509例绿色就诊通道患者经过超声专科评估后,8例(1.6%)患者选择随访观察,501例(98.4%)患者进行FNAB,绿色就诊通道患者接受穿刺的平均时间为3d(非绿色就诊通道患者为35d)。绿色就诊通道和非绿色就诊通道的TBSRTC结果分别为Ⅰ类(11例,2.1%;81例,15.9%),Ⅱ类(25例,5.0%;96例,18.9%),Ⅲ类(58例,11%;84例,166%),Ⅳ类(8例,1.6%;19例,3.7%),Ⅴ类(39例,7.7%;45例,8.9%)和Ⅵ类(360例,71%;182例,35.7%)。两组患者的无效率、不能诊断率、良性率和恶性率的差异均有统计学意义(P<0.01)。结论 甲状腺恶性肿瘤绿色就诊通道的建立,缩短了患者就诊时间,降低了穿刺的无效率、不能诊断率和良性率,提高了穿刺的恶性率,具有重要的临床价值。
关键词:  超声  甲状腺  恶性肿瘤  绿色就诊通道
DOI:
基金项目:四川省科技厅科技支撑计划项目(2015SZ0159)
The clinical value of therapeutic greenway for thyroid malignancies
ZHOU Jiehong,ZHOU Jie,MA Buyun,HE Yushuang
(West China Hospital, Sichuan University)
Abstract:
Objective To discuss the clinical value of thyroid malignancies therapeutic greenway. Methods From Jan. 2016 to Sep.2016 of West China Hospital, 509 patients whose TIRADs classifications were higher than 3B were included. Bethesda system was usded for reporting thyroid Cytopathology (TBSRTC) for cytologic diagnosis Results 509 greenway patients underwent specific thyroid ultrasound examination, 501 patients (501/509, 98.4%) underwent FNAB and 8(8/509, 1.6%) were followed up. The average wait FNAB time was 3 days of greenway patients. However non-greenway patients needed wait 35 days on average. The TBSRTC results were I type(11 cases,21%;81 cases,159%),Ⅱtype(25 cases, 5.0%;96 cases, 189%),Ⅲ type(58 cases, 11%;84 cases, 16.6%),Ⅳ type(8 cases,1.6%;19 cases, 37%),Ⅴ type(39 cases, 7.7%;45 cases, 8.9%)和Ⅵ type(360 cases, 71%;182 cases, 35.7%) of greenway and non-greenway patients respectively. Difference of invalid rate, non diagnostic rate, benign and malignant rate between the two groups was significant(P<0.01). Conclusion Greenway for patients with thyroid carcinomas can not only reduce waiting time, but also decrease invalid rate, non diagnostic rate, and benign rate of aspiration biopsy.
Key words:  Ultrasound  Thyroid  Malignancy  Greenway

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