Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
PLoS One. 2013;8(3):e58016. doi: 10.1371/journal.pone.0058016. Epub 2013 Mar 11.
Thyroid large needle aspiration biopsy is disregarded because it is thought to be associated with pain. This is in contrast with our 32 years long experience. We surveyed reports of pain in patients examined with fine needle aspiration biopsy (78, 87.2% women, mean age 59 years) or FNAB+large needle aspiration biopsy (48, 87.5% women, mean age 60 years). Each patient was questioned regarding a) no unpleasant sensation (score "0"); b) unpleasant sensation ("1"); c) mild pain (no analgesic used; "2"); or d) pain (analgesic used; "3"). The mean size of the needle used was for FNAB 22.3±0.7 or 20.8±1 gauge in the fine needle aspiration or fine needle aspiration plus large needle aspiration biopsy group, respectively (p<.0001). The number of percutaneous punctures was higher in the fine needle aspiration plus large needle aspiration biopsy group. However, the pain score in the fine needle aspiration biopsy or fine needle aspiration biopsy plus large needle aspiration biopsy group was not significantly different. Large needle aspiration biopsy after fine needle aspiration biopsy does not add any discomfort or pain and therefore in light of the demonstrable benefits, should be included in clinical algorithms for the evaluation of thyroid nodules.
甲状腺细针抽吸活检被忽视了，因为人们认为它与疼痛有关。这与我们 32 年的经验形成了对比。我们调查了接受细针抽吸活检（78 例，87.2%为女性，平均年龄 59 岁）或细针抽吸活检+大针头抽吸活检（48 例，87.5%为女性，平均年龄 60 岁）检查的患者的疼痛报告。每位患者都被问到以下问题：a）无不适感（评分“0”）；b）不适感（“1”）；c）轻度疼痛（未使用镇痛药；“2”）；或 d）疼痛（使用镇痛药；“3”）。细针抽吸活检中使用的针的平均直径为 22.3±0.7 或 20.8±1 号，而在细针抽吸加大针头抽吸活检组中分别为 22.3±0.7 或 20.8±1 号（p<.0001）。细针抽吸加大针头抽吸活检组的经皮穿刺次数较高。然而，细针抽吸活检或细针抽吸活检+大针头抽吸活检组的疼痛评分无显著差异。细针抽吸活检后进行大针头抽吸活检不会增加任何不适或疼痛，因此，鉴于其明显的益处，应将其纳入甲状腺结节评估的临床算法中。
