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[经皮肝活检]

[Percutaneous biopsy of the liver].

作者信息

Skladaný L, Jarcuska P, Oltman M, Hrusovský S

机构信息

Interná klinika NsP F. D. Roosevelta, Banská Bystrica, Slovenská republika.

出版信息

Vnitr Lek. 2003 Aug;49(8):679-83.

Abstract

Percutaneous liver biopsy represents the most specific examination of the nature and severity of liver diseases. P. Ehrlich was the first physician in history having done the intervention in 1880. The new history begins with the Menghini's publication on s.c. one-second biopsy in 1957. The present paper deals exclusively with diffuse diseases of the liver including the most frequent ones--virus hepatitis, alcohol and non-alcohol steatohepatitis. The contraindications include mainly coagulation disorders and non-cooperative patients. The percutaneous biopsy is mostly executed after ultrasonographic examination or under the control of various image-forming techniques and by means of various types of needles; the authors analyze advantages and disadvantages of individual techniques. If the contraindications are respected, the percutaneous biopsy is a safe method of examination, which may be done on out-patient basis. A large series of complications exists, but their frequency is generally low. Morbidity is referred in 0.2% of patients, the most frequent complications being pain and hypotension from vaso-vagal reactions, extensive intraperitoneal bleeding and hemobilia. Mortality is extremely low, the mean in large studies being 0.001%.

摘要

经皮肝活检是对肝脏疾病的性质和严重程度最具特异性的检查。保罗·埃尔利希是历史上第一位在1880年进行此项干预的医生。新的历史始于1957年门吉尼发表的关于皮下一秒钟活检的文章。本文专门论述肝脏的弥漫性疾病,包括最常见的疾病——病毒性肝炎、酒精性和非酒精性脂肪性肝炎。禁忌证主要包括凝血功能障碍和不合作的患者。经皮活检大多在超声检查后或在各种成像技术的控制下,借助各种类型的穿刺针进行;作者分析了各种技术的优缺点。如果遵守禁忌证,经皮活检是一种安全的检查方法,可以在门诊进行。存在一系列并发症,但总体发生率较低。0.2%的患者出现并发症,最常见的并发症是血管迷走反应引起的疼痛和低血压、广泛的腹腔内出血和胆道出血。死亡率极低,大型研究中的平均死亡率为0.001%。

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