Second Medical Clinic, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
J Otolaryngol Head Neck Surg. 2010 Oct;39(5):532-41.
Thyroid fine-needle biopsy (FNB) is the procedure of choice in the preoperative management of thyroid nodules because of its accuracy and cost-effectiveness. Minor hematomas are the most common complications, but their morbidity is usually negligible. On the other hand, massive hematomas seem to be rare, but life-threatening, if the performer is unaware or careless and the patient is not adequately informed. In this review, we tried to summarize all reported blood extravasation-related post-FNB complications (hemorrhage, hematomas, and secondary hemangiomas) and provide useful hints to avoid them.
Systematic review of the literature.
Second Medical Clinic of Aristotle University of Thessaloniki in Greece.
Computerized advanced search for primary evidence was performed in the PubMed (Public/Publisher MEDLINE) electronic database. The search was not limited by publication time or English language.
The reported incidence of blood extravasation-related complications during or after FNB ranges between 1.9 and 6.4% in different studies. This variability is possibly due to definition or record biases. Intranodular hemorrhage within the cystic part of complex nodules following fluid aspiration seems to be even more frequent. Seven cases of post-FNB life-threatening massive hematomas resulting in airway obstruction were found as well as four described cases with secondary hemangioma attributed to FNB.
Despite the potential risk of post-FNB hemorrhage, hematomas, or secondary hemangiomas, the overall usefulness and safety of FNB are not questionable, considering the large number of FNBs performed worldwide everyday.
甲状腺细针穿刺活检（FNB）是术前甲状腺结节管理的首选方法，因为它具有准确性和成本效益。小血肿是最常见的并发症，但通常可以忽略不计。另一方面，大量血肿似乎很少见，但如果操作者没有意识到或不小心，并且患者没有得到充分告知，就会有生命危险。在这篇综述中，我们试图总结所有报告的与 FNB 后出血相关的并发症（出血、血肿和继发性血管瘤），并提供有用的提示以避免这些并发症。
文献的系统回顾。
希腊亚里士多德大学第二医学诊所。
在 PubMed（公共/出版商 MEDLINE）电子数据库中进行了原发性证据的计算机高级搜索。搜索不受发表时间或英语语言的限制。
不同研究中，FNB 期间或之后发生与血液外渗相关的并发症的报告发生率在 1.9%至 6.4%之间。这种变异性可能是由于定义或记录偏差所致。在囊性部分的复杂结节内的结节内出血似乎更为常见。我们还发现了 7 例 FNB 后危及生命的大量血肿导致气道阻塞的病例，以及 4 例归因于 FNB 的继发性血管瘤病例。
尽管存在 FNB 后出血、血肿或继发性血管瘤的潜在风险，但考虑到全球每天进行的大量 FNB，其总体有用性和安全性是不容置疑的。
