發(fā)布時(shí)間：2018-03-17 04:27

  本文選題：細(xì)針穿吸細(xì)胞學(xué)檢查　切入點(diǎn)：腮腺腫塊　出處：《安徽醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的評(píng)價(jià)細(xì)針穿吸細(xì)胞學(xué)檢查對(duì)腮腺區(qū)腫塊診斷及手術(shù)切口設(shè)計(jì)的應(yīng)用評(píng)價(jià)。 方法實(shí)驗(yàn)對(duì)象是151例腮腺區(qū)腫塊的患者，這些患者術(shù)前均已行細(xì)針穿吸細(xì)胞學(xué)檢查，穿刺檢查初步診斷為炎癥、良性腫瘤腫塊、高度懷疑為惡性腫瘤和其他病變等，臨床上可根據(jù)穿刺結(jié)果設(shè)計(jì)手術(shù)切口及手術(shù)方案，所有患者均備術(shù)中快速冰凍，穿刺和術(shù)中快速冰凍結(jié)果與術(shù)后常規(guī)病理作診斷對(duì)照，再根據(jù)術(shù)中快速冰凍病理檢查結(jié)果進(jìn)一步調(diào)整手術(shù)切口及手術(shù)方案，以達(dá)到最佳治療效果。 結(jié)果細(xì)胞學(xué)檢查確定腫塊性質(zhì)的準(zhǔn)確率約為93.4%，術(shù)中冰凍病理診斷的準(zhǔn)確率約為97.3%，細(xì)胞學(xué)檢查的診斷與術(shù)后常規(guī)的組織病理診斷符合率基本一致，良性腫瘤為93.9%，惡性腫瘤為92.3%。穿刺結(jié)果顯示為炎癥的患者，先行抗炎治療，根據(jù)病情確定是否需行手術(shù)治療。穿刺結(jié)果為良性腫瘤的患者，根據(jù)臨床表現(xiàn)及體征，設(shè)計(jì)局部最符合臨床美容的手術(shù)切口，，切除腫塊，術(shù)中行快速冰凍病理結(jié)果為惡性，調(diào)整手術(shù)切口，行大范圍根治性的手術(shù)，以防止復(fù)發(fā)。穿刺結(jié)果為惡性腫瘤的患者，先行局部美容切口，術(shù)中行快速冰凍病理檢查，結(jié)果為良性，即按良性腫瘤手術(shù)原則切除腫塊，術(shù)中行快速冰凍病理結(jié)果為惡性，調(diào)整手術(shù)切口，行大范圍根治性的手術(shù)，以防止復(fù)發(fā)。根據(jù)穿刺細(xì)胞學(xué)診斷及術(shù)中快速病理診斷設(shè)計(jì)手術(shù)切口，制定手術(shù)方案，患者術(shù)后面部外形畸變相對(duì)小，有利于形態(tài)和功能的恢復(fù),手術(shù)未發(fā)生神經(jīng)損傷、涎漏和感染等不良的并發(fā)癥。 結(jié)論細(xì)針穿吸細(xì)胞學(xué)檢查結(jié)合術(shù)中快速冰凍病理檢查在腮腺區(qū)腫塊的診治中有重要作用，這種檢查方法，快速并且經(jīng)濟(jì)有效，經(jīng)過(guò)術(shù)后隨訪，并發(fā)癥相對(duì)較少。通過(guò)與術(shù)后的常規(guī)病理對(duì)照，準(zhǔn)確率相對(duì)較高，是一種有較好診斷價(jià)值的診斷手段。
[Abstract]:Objective to evaluate the application of fine needle aspiration cytology in the diagnosis and surgical incision design of parotid gland masses. Methods 151 patients with parotid gland mass were examined by fine needle aspiration cytology before operation. The initial diagnosis was inflammation, benign tumor mass, highly suspected malignant tumor and other pathological changes. According to the results of puncture, surgical incision and surgical plan can be designed in clinic. All patients are prepared for intraoperative rapid freezing, and the results of puncture and intraoperative freezing are compared with routine pathology after operation. In order to achieve the best therapeutic effect, the surgical incision and operation plan were further adjusted according to the results of intraoperative frozen pathological examination. Results the accuracy of cytological examination in determining the nature of tumor was about 93.4 and the accuracy of intraoperative frozen pathological diagnosis was about 97.3.The accuracy of cytological examination was basically consistent with that of postoperative routine histopathological diagnosis. The number of benign tumors was 93.9 and that of malignant tumors was 92.3.The puncture results showed that the patients with inflammation were treated with anti-inflammatory therapy first. According to the clinical manifestations and signs, the patients with benign tumors were diagnosed as benign tumors according to their clinical manifestations and signs. Design the local surgical incision which is the most suitable for clinical beauty, remove the mass, perform fast frozen pathological results as malignant, adjust the surgical incision, and perform a wide range of radical surgery to prevent recurrence. Local cosmetic incision was performed first, and rapid frozen pathological examination was performed during the operation. The result was benign, that is, the tumor was excised according to the principle of benign tumor surgery, and the result of rapid frozen pathology was malignant during the operation. The surgical incision was adjusted, and a wide range of radical surgery was performed. In order to prevent recurrence, the surgical incision was designed according to the diagnosis of puncture cytology and the rapid pathological diagnosis during operation, and the operative plan was formulated. The appearance distortion of the patient's face was relatively small after operation, which was beneficial to the recovery of morphology and function, and no nerve injury occurred in the operation. Poor complications such as salivary leakage and infection. Conclusion the fine needle aspiration cytology combined with intraoperative frozen pathological examination plays an important role in the diagnosis and treatment of parotid gland masses. Compared with conventional pathology, the rate of accuracy is relatively high, which is a valuable diagnostic method.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R782.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 馬艷艷;劉曉勇;吳洪儒;王鳳光;汪育苗;;涎腺腫塊的細(xì)針吸取細(xì)胞學(xué)診斷研究[J];北京口腔醫(yī)學(xué);2007年02期

2 王紅梅;孟慶更;余小蒙;;細(xì)針吸取細(xì)胞學(xué)檢查在臨床病理診斷中的應(yīng)用[J];北京醫(yī)學(xué);2011年04期

3 唐應(yīng)成,梁利斌,楊瑞仙;146例頭頸部炎性淋巴結(jié)的細(xì)針吸取細(xì)胞學(xué)診斷體會(huì)及誤診分析[J];重慶醫(yī)學(xué);2004年09期

4 呂霞;謝榜昆;黃文波;梁爽;;正常腮腺64層螺旋CT灌注成像的初步研究[J];廣東醫(yī)學(xué);2009年11期

5 馬青松;陳冰;王敏;馮陸冰;馬廣貞;周莉;解建軍;;細(xì)針吸取細(xì)胞塊及細(xì)針吸取細(xì)胞學(xué)聯(lián)合應(yīng)用對(duì)涎腺腫瘤的診斷價(jià)值[J];中華實(shí)用診斷與治療雜志;2009年09期

6 鄭蒼尚;腮腺腫物細(xì)針吸取細(xì)胞學(xué)定性分類診斷——附96例報(bào)告[J];華西口腔醫(yī)學(xué)雜志;2002年01期

7 劉拯;;應(yīng)用干式化學(xué)法初篩檢測(cè)獻(xiàn)血者ALT效果分析[J];實(shí)驗(yàn)與檢驗(yàn)醫(yī)學(xué);2011年05期

8 周泉;;腮腺腫物26例誤診原因分析[J];臨床誤診誤治;2009年11期

9 姚宇琪,孫維綱;細(xì)針吸取細(xì)胞學(xué)檢查漏誤診原因分析及對(duì)策[J];四川腫瘤防治;2001年01期

10 白燕瓊;吳濤;李世輝;羅輝玉;曾麗;;5054例細(xì)針吸取細(xì)胞學(xué)檢查結(jié)果分析[J];腫瘤預(yù)防與治療;2008年03期

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