摘要
目的比较两种肝组织活检的并发症,探讨半盲穿法肝组织活检的应用技巧。方法选取2002年来完成的肝活检病例2847例,分半盲穿组和超声引导组,穿刺后观察以下并发症的发生率:肝出血,肝周临近脏器损伤,肝区疼痛,胆汁性腹膜炎,血管迷走神经损伤,严重感染等,分析半盲穿法肝活检并发症原因。结果出血率,半盲穿组为0.533%(13?2440),超声引导组为0.491%(2/407),差异无统计学意义(P>0.05)。肝周临近脏器损伤,半盲穿组中气胸发生率为0.164%(4/2440),胸腔积液为0.041%(1/2440),肾损伤为0.082%(2/2440),超声引导组中胸腔积液为0.246%(1/407),其他均为0%,差异无统计学意义(P>0.05)。第1针穿刺失败率,半盲穿组为8.98%(219/2440),超声引导组为0%,两组差异有统计学意义(P<0.05)。严重疼痛,半盲穿组为0.615%(15/2440),超声引导组为0.491%(2/407),两组差异无统计学意义。迷走神经损伤,半盲穿为0.041%(1/2440),超声引导组为0%,差异无统计学意义。胆汁性腹膜炎、严重感染、病死率,两组发生率均为0%,差异无统计学意义。结论虽然超声引导下经皮肝活检是目前最安全可靠的方法,但临床上只要掌握好穿刺技巧,半盲穿法肝活检仍能很好地避免严重并发症的发生,安全可靠地切取肝组织标本。
Objective To compare the complication rates induced by two biopsy methods and explore the safe operational technique of partially ultrasound - guided liver biopsy. Methods liver biopsies were performed from 2002 to 2007 in our hospital . All patients were grouped into a partially anuhrasound - guided group （2440） and an ultrasound - guided group （ 407 ）. The observed complication such as hemorrhage, splanchnic damage include pneumothorax and renal damage, failed puncture, severe pain, cholerperitonitis and vaso- vagal reflection, severe infection were compared between two groups. The reason of complication in partially ultrasound - guided group were analyzed synchronously. Results Fifteen patients, ! 3 in partially ultrasound - guided group（2440）, 2 in ultrasound - guided group （407） had hemorrhage complication, the hemorrhage complication rate between two groups had no significant differences. 7 in partially ultrasound - guided group, but no patient in ultrasound - guided group suffered from splanchnic damage, the rates between two groups also had no significant differences. Liver tissue of 219 patient in partially ultrasound -guided group（2440） failed to be acquired after the first puncture, but there were no patient failed to be punctured in ultrasound - guided group, the rates had significant differences. Seventeen patients, 15 in partially ultrasound -guided group（2440）, 2 in ultrasound -guided group（407） had severe pain and the rate still had no significant differences. There were no complication such as cholerperitonitis and server bacterial infection in both groups. No patient in both groups died. The rates about these three complications were not significant different. Conclusion Although liver biopsy performed under ultrasound - guided puncture is the safest and the most reliable means to take liver tissue, severe complication can also be avoided in liver biopsy under partially ultrasound guidance and appropriate liver tissue can be token safely if we have grasped key operational technique.
出处
《医学研究杂志》
2008年第5期70-72,共3页
Journal of Medical Research
关键词
肝组织
穿刺术
并发症
Liver tissue
Biopsy
Complication
