肝活检的适应证。
The indications for liver biopsy.
机构信息
Institute of Pathology, Ruhr-University Bochum, Germany.
出版信息
Dtsch Arztebl Int. 2012 Jul;109(27-28):477-83. doi: 10.3238/arztebl.2012.0477. Epub 2012 Jul 9.
BACKGROUND
Despite improvements in serological and radiological techniques, liver biopsy remains the most reliable way to diagnose diffuse hepatic disease and hepatic nodules. The indications for this invasive technique must be weighed against the small, but not negligible, risk of a complication.
METHODS
The indications for liver biopsy are summarized on the basis of a selective review of the literature, including the published recommendations and position statements of specialty societies in Germany and abroad. The conclusions are supplemented with an evaluation of the authors' own experience.
RESULTS
The success of liver biopsy depends not only on the selection of the puncture method and on due attention to the relative and absolute contraindications, but also on the experience of the person carrying out the procedure. For patients with hepatitis of various etiologies, liver biopsy is used not only to establish the cause of the disorder, but also to assess the degree of inflammatory activity (grading) and the extent of fibrosis (staging).
CONCLUSION
Liver biopsy enables the reliable diagnosis of hepatic lesions and is an important aid to treatment planning and prognostication.
背景
尽管血清学和影像学技术有所提高，但肝活检仍然是诊断弥漫性肝疾病和肝结节的最可靠方法。这种有创技术的适应证必须与较小但并非可以忽略不计的并发症风险相权衡。
方法
根据对文献的选择性回顾，总结了肝活检的适应证，包括德国和国外专业协会的已发表建议和立场声明。结论部分还结合了作者自身经验的评估。
结果
肝活检的成功不仅取决于穿刺方法的选择以及对相对和绝对禁忌证的关注，还取决于进行该操作的人员的经验。对于各种病因的肝炎患者，肝活检不仅用于确定疾病的原因，还用于评估炎症活动度（分级）和纤维化程度（分期）。
结论
肝活检能够可靠地诊断肝病变，是治疗计划和预后的重要辅助手段。
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