Ultrasound & CT-Guided Chiba Needle (FNAB) — Cov txheej txheem kev khiav hauj lwm & cov lus qhia tswv yim

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Duab - cojFine Needle Aspiration Biopsy (FNAB)siv rab koob Chiba yog lub hauv paus ntawm kev kuaj mob. Hauv qab no yog cov qauv txheej txheem rau ultrasound- thiab CT- cov kev taw qhia.

Ua ntej-Kev Npaj Ua Haujlwm

Labs: coagulation profile, platelet suav, raum / siab ua haujlwm

NPO 4–6 h (abdominal targets)

Qhia kev tso cai

Khoom siv: 21G / 22G (qee zaus 20G) Chiba koob, 2-5% lidocaine, 10 mL syringe, iav slides, 95% ethanol (fixative), xaiv tau coaxial qhia koob

Ultrasound-Qhia FNAB

• Daim ntawv qhia:Xim Doppler txhawm rau txheeb xyuas cov hlab ntsha perilesional; npaj txoj kev luv tshaj plaws kom tsis txhob mob plab, gallbladder, pleura.
• Tshuaj loog:Local infiltration mus rau qib serosal/capsular.
• Kev nce qib:​ Hauv - dav hlau (nyiam dua) lossis tawm - ntawm - dav hlau; tiag-lub sij hawm pom kev ntawm ncej & taub. Ncua ua pa thaum kawg - tas sij hawm.
• Kev xav:Txuas 10 mL syringe; siv 2-5 mL tsis zoo siab; maj mam kiv cua / txav taub 2-3 × hauv qhov txhab; tuav suction thaum tshem tawm.
• Smear:Tshem tawm cov khoom mus rau swb, smear unidirectionally, kho tam sim ntawd hauv 95% ethanol.
• Ntau qhov hla:​ 2–3 qhov chaw sib cais nyob rau hauv tib qhov chaw kho mob txhim kho kom txaus-tshwj xeeb yog cov qog nqaij hlav necrotic.

CT-Guided FNAB (Qhov tob / Obscured Lesions)

Localize nkag point & qhov tob ntawm ua ntej -scan; kos daim tawv nqaij.

Ua ntej rau qhov tob preset; rov ua CT kom paub meej cov lus qhia tsis pub dhau -necrotic feem ntawm lub hom phiaj.

Siv suction, thim, smear li saum toj no.

Lub ntsws nodules:​ Xaiv shortest trans-pulmonary path; zam fissures & cov hlab ntsha loj; tshaj tawm - txheej txheem CXR los txiav txim pneumothorax.

Lub tswv yim los txhim kho Specimen Adequacy

Orient bevel rau cov ntaub so ntswg kom coj mus kuaj; khaws bevel submerged nyob rau hauv lesion.

• Tsis zoo siab:me me (2-3 mL) rau hypercellular / vascular lesions (thyroid, lymphoma); me ntsis siab dua rau fibrous/mucinous lesions.
• Ceev ceev hauv-thiab- tawm:Txo lub sijhawm nyob hauv kom tsis txhob lumen clogging.
• Txoj kev ua Capillary:​ Rau cov kab mob tsis yooj yim, qee tus neeg ua haujlwm siv tsis muaj qhov nqus - cia siab rau kev kos capillary.
• ROSE (Rapid On -Site Evaluation):Cytotech lossis tus kws kho mob tshawb xyuas smears bedside kom paub meej tias qhov txaus ua ntej xaus cov txheej txheem.

Kev Tiv Thaiv Kab Mob

Tag nrho cov teeb meem<1%:

Tus kheej - txwv oozing (feem ntau)

Pneumothorax (lub ntsws biopsy ~ 3–5%) - feem ntau daws nws tus kheej los yog nrog lub siab yooj yim

Tsis tshua muaj kab mob los yog koob tract seeding (<0.01%)

Tshaj tawm - txheej txheem: compress site × 5–10 min, saib 30 min–2 h.

Kev txawj ntse ntawm Chiba koob FNAB nyob rau hauv dual - kev taw qhia kev coj ua ua kom muaj txiaj ntsig zoo tshaj plaws thaum txo qis kev pheej hmoo - lub peev xwm tseem ceeb rau cov kws tshaj lij kev cuam tshuam thiab ultrasound.