300例快速肝穿刺活检术并发症临床分析

伍林柏; 唐振祥; 程书权

300例快速肝穿刺活检术并发症临床分析

桂林市第三人民医院肝病科

详细信息

中图分类号: R575
计量
- 文章访问数: 3772
- HTML全文浏览量: 11
- PDF下载量: 758
- 被引次数: 0
出版历程
- 出版日期: 2011-10-20

Analysis of the complications in 300 cases of rapid liver biopsy

摘要

摘要: 目的总结快速肝穿刺活检术的并发症和处置措施。方法通过术前认真评估患者肝功能状态及出凝血机制,健康教育指导,B超定位,尔后运用进口Magnum 16 G一次性肝穿刺活检针,常规操作1 s快速穿刺,术后局部加压包扎平卧,监测生命体征6 h。结果 300例经上述穿刺,成功298例,成功率为99%。1例送检结果报告为脂肪组织,进行了第2次重复穿刺,1例送检结果报告为膈肌与少量肺组织。术后局部疼痛54例,占18%;血压一过性下降19例,占6.3%;局部过敏12例,占4%;局部轻度红肿2例,占0.7%。结论 1 s快速肝穿刺活检术安全性高,可在多数基层医院普及应用。
- 活组织检查,针吸 /
- 肝疾病
Abstract: Objective To summarize the complications of rapid liver biopsy and handling measures.Methods A second rapid puncture with import disposable biopsy needle (16G) was performed following a careful preoperative assessment of liver function and the coagulation, health education guidance and ultrasound localization.Local pressure dressing and 6-hour ECG monitor was applied after puncture.Results We performed 300 cases of puncture.The success rate was 99%.Among the failure, one was submission of adipose tissue and 2nd repeat biopsy was performed.The other was submission of a few diaphragm and lung tissue.Postoperative partial pain occurred in 54 cases and the rate was 18%.Transient decrease of the blood pressure occurred in 19 cases.Local infection occurred in 12 cases and the rate was 4%, local swelling and redness occurred in 2 cases and the rate was 0.7%.Conclusion A second rapid liver biopsy is safe and it can be popularly applied in grass-roots hospitals.
- biopsy /
- needle

HTML全文

参考文献(19)

[1]Sanai FM, Keeffe EB.Liver biopsy for histological assessment:Thecase against[J].Saudi J Gastroenterol, 2010, 16 (2) :124-132.

[2]Kanamoto M, Shimada M, Ikegami T, et al.Real time elastographyfor noninvasive diagnosis of liver fibrosis[J].J Hepatobiliary Pan-creat Surg, 2009, 16 (4) :463-467.

[3]Weigand K, Weigand K.Percutaneous liver biopsy:retrospectivestudy over 15 years comparing 287 inpatients with 428 outpatients[J].J Gastroenterol Hepatol, 2009, 24 (5) :792-799.

[4]van der Poorten D, Kwok A, Lam T, et al.Twenty-year audit ofpercutaneous liver biopsy in a major Australian teaching hospital[J].Intern Med J, 2006, 36 (11) :692-699.

[5]Landen S, Ballet T, Bollars P, et al.Liver tuberculosis mistakenfor malignancy.The role of needle biopsy[J].Acta GastroenterolBelg, 2010, 73 (2) :278-279.

[6]Karamshi M.Performing a percutaneous liver biopsy in parenchymal liv-er diseases[J].Br J Nurs, 2008, 17 (12) :746-752.

[7]范平, 江军, 冯晓峰, 等.500例经皮肝穿刺活检并发症分析[J].中华消化杂志, 2004, 24 (7) :426.

[8]Pinelo E, Presa J.Outpatient percutaneous liver biopsy:still a good op-tion[J].Eur J Intern Med, 2009, 20 (5) :487-489.

[9]Schwarz KB, Zellos A, Stamato L, et al.Percutaneous liver biopsyin hemophiliac children with chronic hepatitis C virus infection[J].J Pediatr Gastroenterol Nutr, 2008, 46 (4) :423-428.

[10]Sterling RK, Lyons CD, Stravitz RT, et al.Percutaneous liver bi-opsy in adult haemophiliacs with hepatitis C virus:safety of outpa-tient procedure and impact of human immunodeficiency virus coin-fection on the spectrum of liver disease[J].Haemophilia, 2007, 13 (2) :164-171.

[11]Oshrine B, Lehmann LE, Duncan CN.Safety and utility of liver bi-opsy after pediatric hematopoietic stem cell transplantation[J].Pe-diatr Hematol Oncol, 2011, 33 (3) :e92-97.

[12]Wood B, Pearson N, Crisp M, et al.Pseudoaneurysm formation af-ter ultrasound-guided liver biopsy in an obese child[J].SouthMed J, 2009, 102 (4) :432-434.

[13]Yeo WT, Tan LK, Dan YY, et al.Delayed bleeding after liver bi-opsy:a dreaded complication[J].Singapore Med J, 2008, 49 (1) :76-80.

[14]Pen～a LR, Horn TL, Cross CB.Acute pancreatitis secondary to he-mobilia after percutaneous liver biopsy[J].Therap Adv Gastroen-terol, 2009, 2 (3) :165-168.

[15]Padia SA, Baker ME, Schaeffer CJ, et al.Safety and efficacy ofsonographic-guided random real-time core needle biopsy of theliver[J].J Clin Ultrasound, 2009, 37 (3) :138-143.

[16]Chahal P, Levy C, Litzow MR, et al.Utility of liver biopsy in bonemarrow transplant patients[J].J Gastroenterol Hepatol, 2008, 23 (2) :222-225.

[17]Takamori R, Wong LL, Dang C, et al.Needle-tract implantationfrom hepatocellular cancer:is needle biopsy of the liver always neces-sary?[J].Liver Transpl, 2000, 6 (1) :67-72.

[18]Tung WC, Huang YJ, Leung SW, et al.Incidence of needle tractseeding and responses of soft tissue metastasis by hepatocellular car-cinoma postradiotherapy[J].Liver Int, 2007, 27 (2) :192-200.

[19]Skladany L, Jarcuska P, Oltman M, et al.Percutaneous biopsy ofthe liver[J].Vnitr Lek, 2003, 49 (8) :679-683.

施引文献

资源附件(0)

访问统计