61例经颈静脉肝脏穿刺活组织检查术临床应用的评价  

Evaluation of clinical application of transjugular liver biopsy in 61 cases

作　　者：张冠华 王民[1] 陈广[2] 尉建安 马红[1] 欧晓娟[1] 王宇[1] Zhang Guanhua;Wang Min;Chen Guang;Yu Jian'an;Ma Hong;Ou Xiaojuan;Wang Yu(Liver Research Center,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Interventional Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院肝病中心,国家消化系统疾病临床医学研究中心,100050 [2]首都医科大学附属北京友谊医院放射介入科,100050

出　　处：《中华肝脏病杂志》2020年第11期949-953,共5页Chinese Journal of Hepatology

基　　金：首都临床特色应用研究与成果推广(Z171100001017037);北京市卫生系统高层次卫生技术人才学科骨干资助项目(2015-3-003);北京市医院管理中心消化内科学科协同发展中心专项经费资助(XXT04);王宝恩肝纤维化研究基金(CFHPC2019060)。

摘　　要：目的评价经颈静脉肝脏穿刺活组织检查术(TJLB)在临床应用中的效果及安全性。方法回顾性总结2017年11月至2019年3月于首都医科大学附属北京友谊医院行TJLB患者的临床资料。对临床特点、穿刺的适应证与并发症、标本质量进行分析。结果行TJLB的61例患者中男性32例,女性29例,年龄16~79岁。存在凝血功能异常的患者共43例(70.5%),其中凝血酶原时间活动度最低为39%,血小板计数最低为24×10^9/L。存在肝周积液38例(62.3%)。过度肥胖1例,体质量指数为31 kg/m^2。56例(91.8%)患者成功进行穿刺术。51例(83.6%)组织标本可进行肝脏病理学诊断。5例(8.2%)患者出现严重并发症,14例(23.0%)患者出现轻微并发症,没有患者死亡。结论对于存在经皮肝脏穿刺活组织检查术禁忌证的患者,TJLB是一种安全可行的方法。Objective To evaluate the effectiveness and safety of transjugular liver biopsy(TJLB)in clinical applications.Methods Clinical data of patients who underwent TJLB in the Beijing Friendship Hospital Affiliated to Capital Medical University from November 2017 to March 2019 were retrospectively reviewed.Clinical characteristics,indications and biopsy complications and the samples quality were analyzed.Results Among 61 cases who underwent TJLB,32 were males and 29 were females,aged 16 to 79 years.There were 43 cases(70.5%)with abnormal coagulation function,among which the prothrombin time activity percentage(39%)and platelet count(24×10^9/L)were lowest.38 cases(62.3%)had perihepatic fluid.One case was obese,and had a body mass index of 31kg/m^2.56 cases(91.8%)were successfully biopsied.51 cases(83.6%)liver tissue samples were assessed with pathological diagnosis.Five cases(8.2%)had serious complications.14 cases(23.0%)had mild complications,and no patients died.Conclusion TJLB is a safe and feasible method for patients who have contraindications to percutaneous liver biopsy.

关 键 词：肝疾病 肝脏活组织检查术 经颈静脉 组织标本质量 并发症 

分 类 号：R657.3[医药卫生—外科学]