Ahn Dongbin, Roh Jae-Hyung, Kim Jeong Kyu
Departments of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Cardiology, School of Medicine, Kyungpook National University, Daegu, Korea.
J Ultrasound Med. 2017 Jul;36(7):1339-1346. doi: 10.7863/ultra.16.05045. Epub 2017 Apr 3.
We compared the complications and diagnostic adequacy of ultrasound (US)-guided core needle biopsy (CNB) for head and neck mass lesions between patients who did and did not receive antiplatelet/anticoagulation therapy.
This study was designed as a prospective case study including 146 consecutive patients who underwent US-guided CNB for head and neck mass lesions. Of these, 32 patients were undergoing antiplatelet/anticoagulation therapy involving aspirin, clopidogrel, cilostazol, and warfarin.
None of the patients had clinical bleeding/hematoma in either group. Subclinical bleeding/hematoma recognized only by a US examination was not significantly different between the groups (P = .229). No other complications were noticed. The rate of unsatisfactory sampling was also not different between the groups (P > .999). Furthermore, when patients receiving aspirin (n = 18) were reclassified into the no-antiplatelet/anticoagulation therapy group, there was still no significant difference in the incidences of complications compared with the patients receiving clopidogrel, cilostazol, or warfarin (n = 14).
Our study suggests that US-guided CNB is safe and provides good diagnostic results without necessitating the discontinuation of antiplatelet/anticoagulation therapy in patients with head and neck mass lesions. However, as this was a preliminary study, the cohort was relatively small. Larger studies are needed to confirm our findings.
我们比较了接受和未接受抗血小板/抗凝治疗的患者中，超声（US）引导下的头颈部肿块病变粗针穿刺活检（CNB）的并发症和诊断充分性。
本研究设计为一项前瞻性病例研究，纳入了146例连续接受US引导下的头颈部肿块病变CNB的患者。其中，32例患者正在接受涉及阿司匹林、氯吡格雷、西洛他唑和华法林的抗血小板/抗凝治疗。
两组患者均未出现临床出血/血肿。仅通过超声检查发现的亚临床出血/血肿在两组之间无显著差异（P = 0.229）。未发现其他并发症。两组的采样不满意率也无差异（P > 0.999）。此外，将接受阿司匹林治疗的患者（n = 18）重新分类为未接受抗血小板/抗凝治疗组后，与接受氯吡格雷、西洛他唑或华法林治疗的患者（n = 14）相比，并发症发生率仍无显著差异。
我们的研究表明，对于头颈部肿块病变患者，US引导下的CNB是安全的，且无需停用抗血小板/抗凝治疗即可提供良好的诊断结果。然而，由于这是一项初步研究，队列相对较小。需要更大规模的研究来证实我们的发现。
