彩超引导肝移植患者多次反复肝组织穿刺活检安全性的评价附350例(次)肝穿病例分析  

Safety Evaluation with Serial Colour Ultrasound-guided Liver Biopsy for Liver Transplantation Patients——Analysis of 350 Consecutive Patients

作　　者：唐缨[1] 潘澄[1] 王玉红[1] 武洪涛[1] 毛鹏[1] 沈中阳[1] 

机构地区：[1]天津第一中心医院移植外科B超室,天津市300192

出　　处：《中国超声医学杂志》2003年第5期375-377,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :肝穿组织活检迄今为止仍然是肝移植术后诊断排斥反应、制定治疗计划、判断预后的唯一手段。本研究评价连续反复肝组织穿刺的安全性及如何选择最佳的肝穿手术时机。方法 :1 .　 350例 (次 )患者由经验丰富的超声医师利用彩超引导和自动活检针进行了肝穿活检 ;2 .　通过彩超引导肝穿刺 ,利用高敏感度彩色多普勒 ,避开肝穿部位特别是肝表面的大血管 ;3.　将患者按肝功能、肝穿刺活检的时间、肝穿刺的次数及间隔时间的不同进行分组 ;(4)于肝穿术后给予加压包扎及制动。结果 :1 .　彩超引导可大大提高肝穿活检的安全性 ;2 .凝血酶原时间延长 1倍以上者 ,肝穿需慎重 ;3.　连续反复肝穿、肝穿的时间间隔与肝穿的安全性无明显相关性 ;4.　术后加压包扎及制动对提高肝穿的安全性有一定帮助。结论Objective:Liver biopsy currently is the only definitive means to diagnose post liver transplantation rejection This is particularly important for deciding effective management strategies in time In this study, we estimated the safety of serial ultrasound guided liver biopsy and the optimal operation occasion to be chosen Methods:(1)Three hundred fifty patients underwent liver biopsies performed by an experienced radiologist using ultrasound guidance and an automated biopsy needle;(2)Liver puncture was guided with high sensitivity color Doppler to make sure there was no large vessels in the puncture region especially on the liver surface;(3)Patients were grouped according to the liver function tests and to the date, frequency and intervals of biopsy;(4)Ultr asoundguided liver biopsy should be operated only by those experienced scanners Results:(1)Color ultras ound raised the reliability of liver biopsy notably;(2)We paid great attention to the patients whose prothrombin time(PT) was prolonged more than one time;(3)No significant correlation was observed between the reliability of liver biopsy with repeated times and intervals of liver biopsy;(4)Compressive bandages and immobilization raised the safety after liver biopsy Conclusions:Ultrasound guided serial repeated liver biopsy is an excellent diagnostic tool possessing high safety

关 键 词：彩超引导 肝移植 多次连续肝组织穿刺活检 安全性 诊断 术后免疫排斥反应 

分 类 号：R445.1[医药卫生—影像医学与核医学]