甲状腺结节细针穿刺后急性呼吸窘迫：病例报告及文献复习
Acute respiratory distress following fine needle aspiration of thyroid nodule: case report and review of the literature.
作者信息
Donatini G, Masoni T, Ricci V, D'Elia M, Guadagni A, Baldetti G, Viganò M, Rizzo D, Manfredini G, Uggeri G
机构信息
General Surgery Unit, Massa Hospital, Massa Carrara, Italy.
出版信息
G Chir. 2010 Aug-Sep;31(8-9):387-9.
BACKGROUND
Fine needle aspiration (FNA) is a widely used practice to assess thyroid lesions, with a low morbidity rate. Although neck hematomas following this procedure are quite common, only three cases of massive hemorrhage causing acute airways obstruction have been previously described.
CASE REPORT
We report the case of a 74 years old female with acute respiratory distress following ultrasound-guided FNA for a right paraisthmic thyroid nodule. The patient was admitted to the Emergency Room (ER) 6 hours after the procedure with a large neck hematoma compressing the cervical trachea and requiring surgical decompression. Patient underwent endotracheal intubation followed by isthmectomy and evacuation of the hematoma. Extubation was made 24 hours later in the Intensive Care Unit and the patient was discharged after 48 hours uneventfully.
CONCLUSIONS
Acute thyroid hemorrhage following FNA is very rare but still possible. Prompt intervention is mandatory for patients with rapidly evolving symptoms.
背景
细针穿刺抽吸术（FNA）是评估甲状腺病变的一种广泛应用的方法，发病率较低。尽管该操作后颈部血肿相当常见，但此前仅报道过3例因大量出血导致急性气道梗阻的病例。
病例报告
我们报告一例74岁女性，在超声引导下对右侧甲状腺峡旁结节进行FNA后出现急性呼吸窘迫。患者在术后6小时因巨大颈部血肿压迫颈段气管而被送入急诊室，需要手术减压。患者接受了气管插管，随后进行了峡部切除术并清除血肿。24小时后在重症监护病房拔管，患者48小时后顺利出院。
结论
FNA后急性甲状腺出血非常罕见，但仍有可能发生。对于症状迅速发展的患者，必须立即进行干预。
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