经颈静脉肝穿刺活检术在弥漫性肝病中的临床应用价值  

Clinical application of transjugular liver biopsy in diffuse liver disease

作　　者：周粟 陈天佑 施裕新 侯毅斌 杨柏帅 李清涛 何阳 袁敏 ZHOU Su;CHEN Tian-you;SHI Yu-xin(Department of Interventional Radiology,Public Health Clinical Center Affilited to Fudan University,Shanghai 201508,China)

机构地区：[1]上海市(复旦大学附属)公共卫生临床中心介入科,上海201508

出　　处：《放射学实践》2022年第1期68-71,共4页Radiologic Practice

基　　金：上海市公共卫生临床中心院级科研课题(KY-GW-2019-09)。

摘　　要：目的:探讨经颈静脉肝穿刺活检术(TJLB)在弥漫性肝病中的临床应用价值。方法:回顾性分析2019年6月-2020年11月在我院接受TJLB的35例弥漫性肝病患者的病例资料,对一般资料、技术成功率、组织学标本充分性、手术操作时间、穿刺次数、并发症发生率等情况进行分析。结果:10例凝血酶原时间延长>6 s, 25例国际标准化比值(INR)>1.3,18例血小板计数<60×10^(9)/L,3例存在大量腹腔积液;35例患者中34例取得足够肝组织标本量,满足病理诊断要求,TJLB技术成功率为97.1%(34/35);手术操作时间为(31.1±5.8) min,平均每例穿刺次数为(3.5±1.0)次,无严重并发症发生。结论:对于存在经皮肝穿刺活检禁忌的弥漫性肝病患者,TJLB是一种安全、有效的方法,值得临床推广应用。Objective:To investigate the clinical application of transjugular liver biopsy(TJLB) in patients with diffuse liver disease. Methods:Retrospective analysis was performed on 35 patients with diffuse liver disease who underwent TJLB in our hospital from June 2019 to November 2020.General data, technical success rate, histological specimen adequacy, operation time, number of punctures, and the incidence of complications were summarized and analyzed.Results:The prothrombin time was prolonged >6 s in 10 cases, international normalized ratio(INR)>1.3 in 25 cases, platelet count <60×10^(9)/L in 18 cases, and massive peritoneal effusion in 3 cases.The technical success rate of TJLB was 97.1%,and 34 cases obtained enough liver tissue samples to meet the requirements of pathological diagnosis.The operation time was(31.1±5.8)min, and the average number of punctures was 3.5±1.0 for each patient.No serious complications occurred.Conclusion:For patients with diffuse liver disease contraindicated for percutaneous liver biopsy, TJLB is a safe and effective method, which is worth of clinical application.

关 键 词：弥漫性肝病 肝穿刺活检术 经颈静脉肝穿刺活检术 经皮肝穿刺活检 磁共振成像 

分 类 号：R657.3[医药卫生—外科学] R445.2[医药卫生—临床医学]