经颈静脉肝组织活检术的临床应用  

Clinical application of transjugular liver biopsy

作　　者：朱义江 成德雷 周春泽 吕维富 Yi-Jiang Zhu;De-Lei Cheng;Chun-Ze Zhou;Wei-Fu Lv(Department of Interventional Radiology,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,Anhui Province,China)

机构地区：[1]中国科学技术大学附属第一医院介入放射科,安徽省合肥市230001

出　　处：《世界华人消化杂志》2020年第23期1200-1205,共6页World Chinese Journal of Digestology

基　　金：安徽省重点研究与开发计划项目,No.202004J07020015.

摘　　要：背景肝组织活检在急性或慢性肝病的诊断与治疗中仍然扮演着非常重要的角色.虽然经皮肝穿刺活检已经广泛应用于临床,但对于经皮肝脏穿刺活检存在禁忌的患者,经颈静脉肝组织活检术(transjugular liver biopsy,TJLB)更是一种安全有效的替代手段.TJLB虽然在国外早已普遍开展,但在国内由于器械的原因,仅可见少数几家医院有相关报道.目的对行经皮肝穿刺活检术存在禁忌或高危危险因素的患者,使用COOK公司生产的LABS 100肝内穿刺活检针行经颈静脉肝组织穿刺活检术的安全性及可行性.方法回顾性分析2019-11/2020-03于我院行TJLB的15例患者的临床资料,包括适应症、手术成功率、并发症及取样结果等,并对其归纳总结.结果15例患者手术成功率为100%,并发症发生率6.7%,且全部患者均取得足够肝组织并获得病理学诊断.结论对于不宜行经皮肝穿刺活检患者,TJLB术是可行且安全有效的手段,虽然目前TJLB在国外已广泛开展,但国内开展甚少.BACKGROUND With the increasing incidence of liver diseases,liver biopsy plays an increasingly important role in the diagnosis and treatment of acute or chronic liver diseases.Although percutaneous liver biopsy has been widely used in clinical practice,transjugular liver biopsy(TJLB)is a safe and effective alternative for patients with contraindications to percutaneous liver biopsy,especially for patients with diffuse liver disease.Although TJLB has been widely carried out abroad,there are only a few related reports in domestic hospitals due to equipment reasons.AIM To discuss the safety and feasibility of using LABS 100 intrahepatic biopsy needle set produced by COOK company for TJLB in patients with contraindications to or high risk factors for percutaneous liver biopsy.METHODS The clinical data of ten patients who underwent TJLB at our hospital from November 2019 to March 2020 were analyzed retrospectively,including indications,success rate of operation,complications,and sampling results.RESULTS The success rate of operation was 100%and the complication rate was 10%,and all patients got enough liver tissue and pathological diagnosis.CONCLUSION TJLB is a safe and effective method for patients who are not suitable for percutaneous liver biopsy.Although TJLB has been widely carried out abroad,it is rarely carried out in China.

关 键 词：经颈静脉肝活检术 肝损伤 肝硬化 肝病 经皮肝穿刺活检 

分 类 号：R575[医药卫生—消化系统] R446.8[医药卫生—内科学]