细针穿吸细胞学检查对腮腺区肿块诊断及手术切口设计的应用评价

发布时间：2018-03-17 04:27

本文选题：细针穿吸细胞学检查　切入点：腮腺肿块　出处：《安徽医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的评价细针穿吸细胞学检查对腮腺区肿块诊断及手术切口设计的应用评价。方法实验对象是151例腮腺区肿块的患者，这些患者术前均已行细针穿吸细胞学检查，穿刺检查初步诊断为炎症、良性肿瘤肿块、高度怀疑为恶性肿瘤和其他病变等，临床上可根据穿刺结果设计手术切口及手术方案，所有患者均备术中快速冰冻，穿刺和术中快速冰冻结果与术后常规病理作诊断对照，再根据术中快速冰冻病理检查结果进一步调整手术切口及手术方案，以达到最佳治疗效果。结果细胞学检查确定肿块性质的准确率约为93.4%，术中冰冻病理诊断的准确率约为97.3%，细胞学检查的诊断与术后常规的组织病理诊断符合率基本一致，良性肿瘤为93.9%，恶性肿瘤为92.3%。穿刺结果显示为炎症的患者，先行抗炎治疗，根据病情确定是否需行手术治疗。穿刺结果为良性肿瘤的患者，根据临床表现及体征，设计局部最符合临床美容的手术切口，，切除肿块，术中行快速冰冻病理结果为恶性，调整手术切口，行大范围根治性的手术，以防止复发。穿刺结果为恶性肿瘤的患者，先行局部美容切口，术中行快速冰冻病理检查，结果为良性，即按良性肿瘤手术原则切除肿块，术中行快速冰冻病理结果为恶性，调整手术切口，行大范围根治性的手术，以防止复发。根据穿刺细胞学诊断及术中快速病理诊断设计手术切口，制定手术方案，患者术后面部外形畸变相对小，有利于形态和功能的恢复,手术未发生神经损伤、涎漏和感染等不良的并发症。结论细针穿吸细胞学检查结合术中快速冰冻病理检查在腮腺区肿块的诊治中有重要作用，这种检查方法，快速并且经济有效，经过术后随访，并发症相对较少。通过与术后的常规病理对照，准确率相对较高，是一种有较好诊断价值的诊断手段。
[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.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R782.7

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