经颈静脉肝穿刺活检在肝硬化患者中的应用研究  

Application study of transjugular liver biopsy in patients with liver cirrhosis

作　　者：陈刚[1] 王涌臻 戴峰[1] 薛晨琪 徐春阳 CHEN Gang;WANG Yongzhen;DAI Feng;XUE Chenqi;XU Chunyang(Intervention Department,Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine/the Second Hospital of Nanjing,Nanjing 210003,China)

机构地区：[1]南京中医药大学附属南京医院/南京市第二医院介入科,江苏南京210003

出　　处：《临床医学研究与实践》2021年第25期57-59,共3页Clinical Research and Practice

基　　金：2018年度南京市卫生科技发展专项资金项目(No.YKK18151)。

摘　　要：目的探讨经颈静脉肝穿刺活检(TJLB)技术在肝硬化患者中的安全性、有效性。方法回顾性分析2018年8月至2019年6月于南京中医药大学附属南京医院消化内科住院行TJLB检查的20例肝硬化患者的临床资料,分析患者术后凝血功能障碍、感染、出血等相关并发症的发生情况及肝穿刺标本完整度、病理检查结果。结果20例进行TJLB检查的患者均取得了可行相关病理学分析的足量肝组织,平均标本长度为(1.26±0.41)cm。17例患者获取了明确的病理诊断,诊断率为85.00%;其中15例患者同期进行了肝静脉压力梯度(HVPG)的测量,无严重并发症发生,腹水的存在或凝血功能障碍均没有增加并发症的发生风险。结论TJLB技术安全有效,即使在有腹水或凝血功能障碍的患者中也是如此,其对肝病和急性肝衰竭的组织学评估具有良好的诊断价值。Objective To explore the safety,effectiveness of transjugular liver biopsy(TJLB)technology in patients with liver cirrhosis.Methods The clinical data of 20 hospitalized patients with liver cirrhosis who underwent TJLB in the gastroenterology department of Nanjing hospital affiliated to Nanjing university of traditional Chinese medicine from August 2018 to June 2019 were retrospectively analyzed,and the occurrence of postoperative complications such as coagulation dysfunction,infection,bleeding,and the completeness of liver puncture specimens,pathological examination results were analyzed.Results In all 20 patients who underwent TJLB,sufficient liver tissue was obtained for viable pathological analysis,with a mean specimen length of(1.26±0.41)cm.Definite pathological diagnosis was obtained in 17 patients,and the diagnostic rate was 85.00%.Hepatic venous pressure gradient(HVPG)was measured simultaneously in 15 of the patients,and no serious complications occurred.The presence of ascites or coagulation dysfunction did not increase the risk of complications.Conclusion TJLB technology is safe and effective,even in patients with ascites or coagulation dysfunction.It has a good diagnostic value for the histological evaluation of liver disease and acute liver failure.

关 键 词：经颈静脉肝穿刺活检 肝硬化 腹水 凝血功能障碍 

分 类 号：R657.31[医药卫生—外科学]