Mbengue M, Ka M M, Leye A, Dia D, Diao A, Dangou J M, Fall B, Moreira-Diop T
Clinique Médicale, CHU A. Le Dantec, Dakar, Sénégal.
Dakar Med. 2003;48(2):99-104.
Our aim was to evaluate practices of percutaneous liver biopsies over the last 11 years in our center in focal or diffuse liver disease. Records of 447 patients who underwent ultrasound-guided liver biopsy between 1998 and 1999 were reviewed. Three experienced physicians performed all liver biopsies with a Menghini needle or fine needle. In all cases the puncture site was determined using prebiopsy ultrasound. Liver biopsies were performed on 423 hospitalized patients and 24 outpatients. The suspicion of primary liver cancer was the indication in 72.7% of the cases. In 75.2% patients definitive or indicative pathological diagnosis were obtained. 208 biopsies out of 229 (90.8%) and 215 cytological punctures out of 239 (89.9%) were interpretable. Histological diagnosis obtained were primary malignamt tumor in 235 cases (58.2%), cirrhosis in 26 cases (6.4%), chronic hepatitis in 32 cases (7.9%), and normal tissue in 56 cases (13.9%). Only 2 hemorrhagic complications requiring blood transfusion (0.4%) and one needle-tract tumor seeding (0.2%) occured 42 months later. We concluded that ultrasound-guided percutaneous liver biopsy is a quick method of assessment increasing the diagnosis yield by this procedure and maintaining low complications.
我们的目的是评估过去11年里我们中心在局灶性或弥漫性肝病中经皮肝活检的操作情况。回顾了1998年至1999年间447例行超声引导下肝活检患者的记录。由三位经验丰富的医生使用Menghini针或细针进行所有肝活检。所有病例均在活检前通过超声确定穿刺部位。对423例住院患者和24例门诊患者进行了肝活检。72.7%的病例以原发性肝癌可疑为指征。75.2%的患者获得了明确或指示性病理诊断。229例活检中有208例（90.8%）以及239例细胞学穿刺中有215例（89.9%）可进行解读。获得的组织学诊断为原发性恶性肿瘤235例（58.2%）、肝硬化26例（6.4%）、慢性肝炎32例（7.9%）、正常组织56例（13.9%）。仅发生了2例需要输血的出血并发症（0.4%）以及1例针道肿瘤种植（0.2%）于42个月后出现。我们得出结论，超声引导下经皮肝活检是一种快速的评估方法，可提高该操作的诊断率并保持低并发症发生率。
