明胶海绵块在肝组织穿刺活检中预防出血的临床价值  

The Clinical Value of Gelatin Sponge in Preventing Bleeding in Liver Tissue Biopsy

作　　者：蔡清源 吴晓敏 陈锦珍 张清泉[1] 易阿玲 刘海伟 谢思培 Cai Qingyuan;Wu Xiaomin;Chen Jinzhen;Zhang Qingquan;Yi Aling;Liu Haiwei;Xie Sipei(Department of Ultrasound,Quanzhou First Hospital Affiliated of Fujian Medical University,Quanzhou,Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院超声科,福建省泉州市362000

出　　处：《中国超声医学杂志》2024年第2期182-184,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探索明胶海绵块在肝组织穿刺活检中预防出血并发症的临床价值。方法选取行肝组织穿刺活检患者共462例,按穿刺顺序分为观察组和对照组,观察组应用明胶海绵块止血。穿刺后即刻应用彩色多普勒超声检查穿刺针道,分析两组穿刺后即刻出血并发症的发生率,以及出血的相关因素。结果观察组和对照组均成功穿刺,穿刺成功率为100%。观察组和对照组的出血并发症发生率、止血时间及操作时长差异有统计学意义(P<0.05)。观察组和对照组的性别、年龄、穿刺部位、国际标准化比值(INR)水平、凝血酶原时间、白蛋白、血小板、脂肪肝差异无统计学意义(P>0.05)。单因素分析显示脂肪肝、凝血酶原时间、白蛋白、INR水平等4项因素对对照组穿刺出血有显著影响(P<0.05),R值显示4个指标与出血相关性大小依次为INR水平、凝血酶原时间、脂肪肝、白蛋白。结论超声引导下肝穿刺活检术前必须纠正患者肝功能和凝血功能,使用同轴针注入明胶海绵块是一项有效的操作,可明显提高穿刺安全性。Objective To explore the clinical value of gelatin sponge in preventing bleeding in liver biopsy.Methods A total of 462 patients who underwent liver biopsy in our hospital and divided into the observation group and the control group according to the order of puncture.The observation group was treated with gelatin sponge for hemostasis.The puncture needle was examined by color Doppler ultrasound immediately after puncture,and the incidence of bleeding complications immediately after puncture and the related factors of bleeding were analyzed in the two groups.Results The puncture success rate was 100%in both groups.There were significant differences in the incidence of bleeding,hemostasis time and operation time between the two groups(P<0.05).There were no significant differences in gender,age,puncture site,international normalized ratio(INR)level,prothrombin time,albumin,platelet and fatty liver between the two groups(P>0.05).Single factor analysis showed that fatty liver,prothrombin time,albumin and INR level had significant effects on puncture bleeding in the control group(P<0.05).R-value showed that the correlation between four indexes and bleeding was INR level,prothrombin time,fatty liver and albumin in order.Conclusions The liver function and coagulation function of patients must be corrected before liver biopsy,and the injection of gelatin sponge with coaxial needle is an effective operation,which can significantly improve the safety of puncture.

关 键 词：肝活检 并发症 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575[医药卫生—诊断学]