超声引导肝穿刺活检并发症及处理对策  

Analysis and management of the complications of ultrasound-guided hepatic puncture biopsy

作　　者：余松远[1] 邓远[1] 屈亚莉 郭丽燕[1] 张绍斌[1] 

机构地区：[1]武汉市医疗救治中心超声介入科,430023

出　　处：《中华超声影像学杂志》2011年第6期496-498,共3页Chinese Journal of Ultrasonography

摘　　要：目的探讨超声引导肝穿刺活检的并发症及处理对策。方法对我院175例超声引导下经皮肝穿265针次活检病例资料进行回顾性分析，总结术后出现的并发症及处理对策，并随访疗效。结果肝穿刺后出现并发症16例（9．1％），其中迷走神经反射5例（2．9％），需要药物缓解的疼痛4例（2．2％），肝包膜下出血3例（1．7％），低血糖反应3例（1．7％），严重腹腔内积血1例（0．6％）。前4项一般并发症经对症处理均能缓解，1例腹腔大量积血经超声造影发现肝出血点，即刻行微波消融治疗止血。结论超声引导肝穿刺活检并发症发生率低；腹腔大量积血为严重并发症，经超声造影引导下肝局部微波消融可有效止血。Objective To investigate the features, prevention and treatment of complications of ultrasound-guided hepatic puncture biopsy. Methods One hundred and seventy-five cases underwent ultrasound-guided hepatic puncture biopsy were retrospectively analyzed. Results The incidence of complications was 16 cases （9.1G）,including 5 cases with vasovagal episodes（2.9%）,4 cases with ache which needed medicine treatment （2.2 %）, 3 cases with hemorrhage in liver capsule （ 1.7 %）, 3 cases with hypoglycemia（1.7%）, 1 case with serve hemorrhage in abdominal cavity（0.6%）. Hemorrhage limited in liver capsule,vasovagal episodes, hypoglycemia and ache were relieved with corresponding treatments. One case with hemorrhage in abdominal cavity was handled with percutaneous microwave ablation therapy guided by contrast-enhanced ultrasound. Conclusions Ultrasound-guided hepatic puncture biopsy has good value and low complication. The most severe complication is hemorrhage, which can be handled with percutaneous microwave ablation therapy guided by contrast-enhanced ultrasound.

关 键 词：超声检查 肝疾病 活组织检查 针吸 手术后并发症 

分 类 号：R735.7[医药卫生—肿瘤]