Pace M, Dotta C, Moretto F, Breda A, Rizzo A, Sanzuol F
Regione Veneto, U.L.S.S. n. 12, Presidio Ospedaliero di Valdobbiadene, Divisione Medica.
Minerva Med. 1990 Jan-Feb;81(1-2):27-44.
A report is presented on patients admitted to hospital with chronic hepatitis or alcoholic cirrhosis of the liver and subjected to diagnostic laboratory tests, ultrasound scans and needle biopsies both non-surgical and during laparoscopy. The laboratory findings were compared with the results of ultrasound scans and biopsies. It was concluded that the diagnostic accuracy of ultrasound scans is sufficient, when backed by anamnestic clinical and laboratory data, to obviate the need for liver biopsy in cases of chronic hepatitis and alcoholic cirrhosis. Nor is biopsy required for differential diagnosis between the two conditions but should be reserved for the setting of diagnostic uncertainty about cancer-cirrhosis, or the presence of hepatoma, liver metastases, ascites or other oedematous forms. It is concluded that the undoubled diagnostic accuracy of biopsy does not compensate for the risk entailed especially for patients of this type.
本文报告了因慢性肝炎或酒精性肝硬化入院的患者,他们接受了诊断性实验室检查、超声扫描以及非手术和腹腔镜检查时的穿刺活检。将实验室检查结果与超声扫描和活检结果进行了比较。得出的结论是,在有临床病史和实验室数据支持的情况下,超声扫描的诊断准确性足以避免在慢性肝炎和酒精性肝硬化病例中进行肝活检。在这两种情况的鉴别诊断中也不需要活检,但活检应保留用于对癌性肝硬化、肝癌、肝转移、腹水或其他水肿形式存在诊断不确定性的情况。得出的结论是,活检虽诊断准确性毋庸置疑,但无法弥补其所带来的风险,尤其是对这类患者而言。