彩色多普勒超声引导下肝脏活组织检查术并发症的防治  

Prevention of complications in liver biopsy guided by color Doppler sonography

作　　者：张瑶[1] 杨学平[1] 王连双[1] 王丽萍[1] 王玥[1] 张记[1] 孙磊[2] 闫杰[3] 

机构地区：[1]首都医科大学附属北京地坛医院超声科,北京100015 [2]首都医科大学附属北京地坛医院病理科,北京100015 [3]首都医科大学附属北京地坛医院肝病一科,北京100015

出　　处：《中国肝脏病杂志（电子版）》2016年第2期68-71,共4页Chinese Journal of Liver Diseases：Electronic Version

基　　金：北京市科委首都临床特色应用研究基金(No.Z131107002213020);北京市卫生系统高层次人才培养计划(No.2013-3-025)

摘　　要：目的通过比较2009年1月至2012年3月和2012年4月至2015年6月两个时期行超声引导下肝脏活组织检查术患者并发症的发生率,评估指导超声引导下肝脏活组织检查的标准规范。方法回顾性分析2009年1月至2015年6月首都医科大学附属北京地坛医院所有经皮行超声引导下肝脏活组织检查患者的资料,根据超声引导下肝脏活组织检查的不同标准规范,将患者分为研究组(2012年4月至2015年6月)和对照组(2009年1月至2012年3月)。比较两组患者肝脏活组织检查后并发症的发生率。结果共纳入行超声引导下肝脏活组织检查的患者5107例,其中研究组2585例,对照组2522例。总并发症发生率为4.8%(245/5107)。研究组中,6例患者发生出血(0.23%),其中腹腔游离出血1例(0.04%),包膜下血肿5例(0.19%);1例患者出现重要器官损伤(肾脏,0.04%);86例患者出现疼痛症状(3.32%)。对照组中,22例患者发生出血(0.87%),其中腹腔游离出血2例(0.08%),包膜下血肿18例(0.71%),胆道出血1例(0.04%),迟发性出血1例(0.04%);130例患者出现疼痛症状(5.15%)。两组并发症的总发生率(3.6%vs.6.0%)、出血率(0.23%vs.0.87%)、肝包膜血肿发生率(0.19%vs.0.71%)、疼痛率(3.32%vs.5.15%)均有显著差异(P值分别为0.001、0.002、0.006、0.001)。结论合理制定彩色多普勒超声引导下肝活组织检查的标准规范有利于降低术后并发症的发生。Objective To evaluate the standard specification in liver biopsy guided by the color Doppler sonography through comparing the rate of complications between the two periods（January 2009 to March 2012 and April 2012 to June 2015）. Methods Medical records of all patients undergoing percutaneous liver biopsy guided by color Doppler sonography from January 2009 to June 2015 in Beijing Ditan Hospital, Capital Medical University were reviewed retrospectively. Patients were divided into treatment group（from April 2012 to June 2015） and control group（from January 2009 to March 2012） based on whether the standard specification was applied when patients undergoing liver biopsy guided by color Doppler sonography. The rates of complications were compared and further furtherly analyzed between the two groups. Results Total of 5107 cases were given liver biopsy guided by the color Doppler sonography, among whom 2585 cases were in treatment group and 2522 cases were in control group. The total complication rate was 4.8 %（245/5107）. In treatment group, bleeding was identified in 6 patients（0.23%）, including one case（0.04%） with free intraperitoneal hemorrhage and 5 cases（0.19%） with subcapsular hematoma. Adjacent organ（kidney） injury was identified in 1 case（0.04%）. Total of 86 patients（3.32%） occured the symptoms of pain. In control group, bleeding was identified in 22 cases（0.97%）, including 2 cases（0.08%） with free hemorrhage, 18 cases（0.71%） with subcapsular hematoma, 1 case（0.04%） with hemobilia, 1 case（0.04%） with delayed bleeding and 130 patients（5.15%） occured the symptoms of pain. There were significant differences in complication rate（3.6% vs. 6.0%）, bleeding rate（0.23% vs. 0.87%）, incidence rate of hepatic capsular hematoma（0.19% vs. 0.71%） and rate of pain（3.32% vs. 5.15%） between treatment group and control group, respectively（P = 0.001, 0.002, 0.006, 0.001）. Conclusion The complication rate of liver biopsy guided by color Doppler son

关 键 词：超声检查 多普勒 彩色 肝脏活组织检查 并发症 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575[医药卫生—诊断学]