内镜超声引导下细针抽吸的基本技术：导丝和抽吸的作用。
Basic techniques in endoscopic ultrasound-guided fine-needle aspiration: Role of a stylet and suction.
机构信息
Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, CO, USA ; Division of Gastroenterology and Hepatology, Veterans Affairs Medical Center, Denver, CO, USA.
出版信息
Endosc Ultrasound. 2014 Jan;3(1):17-21. doi: 10.4103/2303-9027.123008.
Abstract
There are several variables that have been studied to optimize various outcomes of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) such as quality and adequacy of specimens, diagnostic yield of malignancy, accuracy and overall efficiency. Using an evidence-based approach, the objectives of this review are to discuss two key aspects of EUS-FNA: (a) Use of a stylet and (b) use of suction. Level 1 evidence available from randomized controlled trials demonstrates that the use of a stylet during EUS-FNA has no impact on the diagnostic yield of malignancy or the quality of specimens. Air flushing in a slow, controlled fashion is superior to reinsertion of a stylet to express EUS-FNA aspirates. The use of suction should be considered during EUS-FNA of pancreatic masses. However, data from a randomized controlled trial suggest that suction should not be used during EUS-FNA of lymph nodes as it increases bloodiness of specimens obtained and has no impact on the overall diagnostic yield.
摘要
有几个变量已经被研究用于优化内镜超声引导下细针抽吸术（EUS-FNA）的各种结果，如标本的质量和充足性、恶性肿瘤的诊断率、准确性和整体效率。本综述采用循证方法，旨在讨论 EUS-FNA 的两个关键方面：（a）使用导丝和（b）使用抽吸。来自随机对照试验的 1 级证据表明，EUS-FNA 中使用导丝不会影响恶性肿瘤的诊断率或标本的质量。缓慢、受控的空气冲洗优于重新插入导丝以表达 EUS-FNA 抽吸物。在胰腺肿块的 EUS-FNA 中应考虑使用抽吸。然而，来自随机对照试验的数据表明，在 EUS-FNA 淋巴结时不应使用抽吸，因为它会增加获得的标本的血液含量，并且对整体诊断率没有影响。
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2
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3
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4
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5
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