北京协和医院经皮心内膜心肌活检临床操作规范  

Standard Operation Procedure of Percutaneous Endomyocardial Biopsy in Peking Union Medical College Hospital

作　　者：徐希奇 田庄[1,2] 方全 荆志成[1,2] 张抒扬 XU Xiqi;TIAN Zhuang;FANG Quan;JING Zhicheng;ZHANG Shuyang(Department of Cardiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;State Key Laboratory of Complex Severe and Rare Diseases,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院心内科,北京100730 [2]疑难重症及罕见病国家重点实验室,北京100730

出　　处：《协和医学杂志》2021年第3期322-327,共6页Medical Journal of Peking Union Medical College Hospital

基　　金：国家重点研发计划(2016YFC0901502);中国医学科学院医学与健康科技创新工程(2016-I2M-1-002)。

摘　　要：经皮心内膜心肌活检是利用心肌活检钳经外周血管夹取心内膜心肌组织的技术,迄今在临床上应用已超过50年,且相关技术不断更新。目前心内膜心肌活检及心肌病理学诊断已成为诊断心肌炎、心肌病的重要手段。北京协和医院心内科已进行500余例心内膜心肌活检操作,积累了一定的经验,因此特制定经皮心内膜心肌活检临床操作规范,主要包括其适应证、禁忌证、操作要点、标本处理及术后监测等,并提出了并发症的处理策略。由于经皮心内膜心肌活检具有漏检的可能,需与超声心动图、心脏MRI及心血管病理学等方面专业医师密切配合,以减少漏诊、误诊。建议全国心内科医师高度重视并积极开展此项检查,以提高我国心肌炎、心肌病的精准诊断能力。Percutaneous endomyocardial biopsy(EMB)is a technique that biopsy samples are obtained using the bioptome through a peripheral blood vessel.The technique has been used and refined for more than 50 years in clinical application.Now EMB has become an important tool of the diagnosis of myocarditis and cardiomyopathy.The department of cardiology of Peking Union Medical College Hospital(PUMCH)has performed more than 500 cases of EMB and accumulated abundant practical experience.The clinical practice guideline of percutaneous EMB was also established in PUMCH,including indications,contradictions,key points of the operation,sample handling and processing,post-procedure monitoring,and the treatment strategy for potential complications,etc.Due to the limitation of EMB,cardiologists should collaborate with experts on echocardiography,cardiac magnetic resonance and cardiac pathology to decrease the probability of missed diagnosis andmisdiagnosis.Cardiologists should pay much attention to the value of EMB and actively perform EMB to improve the diagnosis level of myocarditis and cardiomyopathy in China.

关 键 词：心肌炎 心肌病 心内膜心肌活检 

分 类 号：R542.2[医药卫生—心血管疾病]