肝穿活检术在诊断早期肝硬化中的应用价值  

Application value of liver biopsy in the diagnosis of early liver cirrhosis

作　　者：张玉婷 沈波 ZHANG Yuting;SHEN Bo(Department of Liver Disease,Yichun People＇s Hospital of Jiangxi Province,Yichun 336000,China;Department of General Surgery,Yichun People＇s Hospital of Jiangxi Province,Yichun 336000,China)

机构地区：[1]江西省宜春市人民医院肝病科,江西宜春336000 [2]江西省宜春市人民医院普外科,江西宜春336000

出　　处：《中国现代医生》2018年第23期87-89,F0003,共4页China Modern Doctor

摘　　要：目的探讨肝穿活检在诊断肝硬化中的应用价值。方法将2013年1月～2017年11月我院接诊的50例疑诊为肝硬化的患者纳入本研究。比较肝穿活检结果与临床诊断结果差异,以临床诊断结果为金标准,分析肝穿活检诊断早期肝硬化的灵敏度、特异度、准确率、阳性预测值以及阴性预测值,并记录肝穿活检的不良反应发生情况。结果肝穿活检结果和临床诊断结果对比,在代偿期肝硬化以及总肝硬化诊断率方面差异无统计学意义(P>0.05);肝穿活检诊断早期肝硬化的灵敏度为97.06%、特异度为87.50%、准确率为94.00%、阳性预测值为94.29%、阴性预测值为93.33%;患者肝穿活检术后,出现局部疼痛10例(20.00%),血压一过性下降2例(4.00%),局部轻度红肿1例(2.00%)。结论肝穿活检在诊断肝硬化中,效果与临床诊断相似,且对于早期肝硬化的诊断灵敏度、准确率均较高,可作为肝硬化诊断的判断方法之一。Objective To explore the application value of liver biopsy in the diagnosis of cirrhosis. Methods A total of 50 patients with suspected cirrhosis admitted in our hospital from January 2013 to November 2017 were included in this study. The difference between liver biopsy results and clinical diagnosis results was compared. With the clinical di- agnosis results as the gold standard, the sensitivity, specificity, accuracy, positive predictive value, and negative predic- tive value of liver biopsy in the diagnosis of early liver cirrhosis were analyzed and the adverse reactions occurred in the liver biopsy were recorded. Results There was no significant difference in diagnosis rate of compensatory liver cir- rhosis and total cirrhosis between the liver biopsy results and clinical diagnosis results （P〉0.05）. The sensitivity, speci- ficity, accuracy, positive predictive value and negative predictive value of liver biopsy in the diagnosis of early liver cirrhosis was 97.06%, 87.50%, 94.00%, 94.29% and 93.33%, respectively. After liver biopsy, there were 10 cases （20.00%） of local pain, 2 cases（4.00%） of transient decrease of blood pressure and 1 case（2.00%） of local mild redness. Conclusion Liver biopsy in the diagnosis of cirrhosis is similar to the clinical diagnosis. The liver biopsy in early liver cirrhosis has high diagnostic sensitivity and accuracy and can be used as a diagnostic method for the diagnosis of cir- rhosis.

关 键 词：肝穿活检 肝硬化 不良反应 

分 类 号：R575.2[医药卫生—消化系统]