Abu-Yousef Monzer M, Larson Joshua H, Kuehn David M, Wu Andrew S, Laroia Archana T
Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
Ultrasound Q. 2011 Sep;27(3):157-9. doi: 10.1097/RUQ.0b013e31822b5681.
We examined records of patients who underwent ultrasound-guided fine needle aspiration biopsy (USGFNAB) of neck lesions to determine whether there was a significantly increased incidence of bleeding complications in patients on antithrombotic and/or anticoagulant (AT/AC) medications compared to patients not receiving AT/AC therapy. Our institutional review board approved this Health Insurance Portability and Accountability Act-compliant retrospective examination of patients' medical data without requiring informed consent. The records of 593 patients (422 women and 171 men ranging from 18 to 91 years of age) who underwent USGFNAB of 788 total neck lesions over an 18-month period were reviewed to determine AT/AC medication used and evidence of USGFNAB-related bleeding complications. Of these, 144 patients (24.3%) were taking one or more AT/AC medications including aspirin, clopidogrel, heparin, and warfarin. The χ2 test was used to assess statistically significant differences in the incidence of USGFNAB-related bleeding complications between patients who were on daily AT/AC medications (test group) and patients who were not (control group). Six USGFNAB-related hematomas (1.0%) occurred. Two hematomas developed in patients on AT/AC medications, and 4 hematomas developed in patients who did not take AT/AC medications (χ = 0.27, df = 1, P = 0.603). This study shows no statistically significant difference in the incidence of hematoma formation after USGFNAB of neck lesions in patients taking AT/AC medications compared to patients not taking AT/AC medications. On the basis of these data, there is no benefit, with regard to incidence of bleeding complications, to discontinuing AT/AC medications in patients undergoing USGFNAB of neck masses.
我们检查了接受颈部病变超声引导下细针穿刺活检（USGFNAB）患者的记录，以确定与未接受抗血栓和/或抗凝（AT/AC）药物治疗的患者相比，使用AT/AC药物的患者出血并发症发生率是否显著增加。我们的机构审查委员会批准了这项符合《健康保险流通与责任法案》的患者医疗数据回顾性检查，无需获得知情同意。回顾了593例患者（422例女性和171例男性，年龄在18至91岁之间）在18个月内对总共788处颈部病变进行USGFNAB的记录，以确定所使用的AT/AC药物以及USGFNAB相关出血并发症的证据。其中，144例患者（24.3%）正在服用一种或多种AT/AC药物，包括阿司匹林、氯吡格雷、肝素和华法林。采用χ2检验评估每日服用AT/AC药物的患者（试验组）和未服用的患者（对照组）之间USGFNAB相关出血并发症发生率的统计学显著差异。发生了6例与USGFNAB相关的血肿（1.0%）。2例血肿发生在服用AT/AC药物的患者中，4例血肿发生在未服用AT/AC药物的患者中（χ = 0.27，自由度 = 1，P = 0.603）。这项研究表明，与未服用AT/AC药物的患者相比，服用AT/AC药物的患者在颈部病变USGFNAB后血肿形成的发生率没有统计学显著差异。基于这些数据，对于接受颈部肿块USGFNAB的患者，在出血并发症发生率方面，停用AT/AC药物没有益处。
