摘要
目的探讨与分析彩超引导下经皮穿刺活检对肝脏病变的诊断及其临床应用价值。方法选择2010年1月至2013年1月来郑州大学第一附属医院经临床诊断为原发性肝癌、转移性肝癌门或肝硬化等肝脏占位性病变患者140例为研究对象，对其均予以彩超引导下经皮穿刺活检，回顾性分析其临床资料。结果140例患者均经彩超引导下经皮穿刺活检或手术病理最后确诊，其中恶性肿瘤120例，占85．71％，良性病变20例，占14．29％。彩超引导下经皮穿刺活检确诊恶性肿瘤118例，良性病变18例，活检未能确诊肝癌2例，肝硬化2例。引导下肝穿刺活检诊断的敏感度高于入院临床诊断、超声诊断，经比较差异有统计学意义（X^2=20．877，11．772，P=0．000，0．001）。引导下肝穿刺活检诊断的特异度明显高于入院临床诊断（X^2=10．989，P=0．001），与超声诊断相比差异无统计学意义（X^2=2．500，P=0．114）。引导下肝穿刺活检诊断的准确度高于入院临床诊断、超声诊断，经比较差异有统计学意义（X^2=29．867，13．737，P：0．000，0．000）。穿刺1次、2次、3次的佳良率分别为100％、93．33％、97．22％，各组的穿刺组织标本满意度比较差异无统计学意义（P〉0．05）。结论彩超引导下经皮穿刺活检对肝脏病变的诊断安全、准确、微创、简便，并对肝脏病变的病理组织学类型进行确定，具有较高的临床价值。
Objective To investigate and analyze the ultrasound guided percutaneous biopsy in diagnosis of liver disease and its clinical application value. Methods To chose 140 patients diagnosed as hepatocellular carcinoma, metastatic liver cancer or cirrhosis and other liver space occupying lesions between January 2010 and January 2013 in the first affiliated hospital of Zhengzhou university as the re search object, they were treated with ultrasound guided pereutaneous biopsy, and their clinical data were retrospectively analyzed. Results One hundred and forty patients were treated by ultrasound guided percutaneous puncture biopsy or operation pathologically confirmed last, including malignant in 120 cases, accounting for 85.71% , 20 cases of benign lesions, accounting for 14.29%. Ultrasound guided pereutaneous puncture biopsy of 118 cases of malignant tumor, 18 cases of benign lesions, 2 cases of biopsy failed to diagnose liver cancer, 2 cases of liver cirrhosis. Guided biopsy diagnosis of liver biopsy sensitivity was higher than that of clinical diagnosis on admission, ultrasound diagnosis, the difference was statistical significant（ X^2 = 20. 877,11. 772, P = 0. 000,0. 001 ）. Guided biopsy of liver puncture under the specificity was significantly higher than the clinical diagnosis on admission （ X^2 = 10. 989, P =0. 001 ）, there was no significant difference compared with the ultrasound diagnosis （X^2 = 2. 500, P =0. 114）. Guided biopsy in the diagnosis of liver puncture accuracy was higher than that of clinical diagnosis on admission, ultrasound diagnosis, the difference was statistical significant （X^2= 29. 867,13. 737, P = 0. 000,0. 000）. The rates of better yield of puncture for 1 times, 2 times and 3 times were 100% , 93.33% , 97.22% , the biopsy specimens satisfaction had no significant difference in each group （ P 〉 0.05 ）. Conclusions Ultrasound guided percutaneous puncture biopsy for liver lesionsis safe, accurate, minimally invasive and simple, it can make sure the histopathological types of liver lesions, with high clinical application value.
出处
《中国实用医刊》
2014年第10期17-19,共3页
Chinese Journal of Practical Medicine
关键词
彩超
穿刺活检
肝脏病变
诊断
Ultrasonography
Biopsy
Liver disease
Diagnosis
