Hayatghaibi Shireen, Ashton Daniel, Cleveland Heather, Kukreja Kamlesh
Texas Children's Hospital, 6701 Fannin St, Ste 470, Houston, TX, 77030-2608, USA.
Baylor College of Medicine, Houston, TX, USA.
Cardiovasc Intervent Radiol. 2017 Dec;40(12):1899-1903. doi: 10.1007/s00270-017-1720-3. Epub 2017 Jun 8.
We retrospectively studied whether a limited 2 h post-biopsy observation period after a percutaneous outpatient ultrasound-guided liver biopsy is a sufficient monitoring period for children.
This study is an IRB-approved retrospective cohort review of consecutive outpatient percutaneous ultrasound-guided liver biopsies from June 01, 2014, to June 30, 2016. A total of 198 biopsies in 192 patients (85 females and 113 males) underwent an outpatient ultrasound-guided liver biopsy between June 01, 2014, and June 30, 2016 (age range 3 weeks-18 years, mean 11.6 years). Outpatient biopsies were performed with a limited patient observation time [median (IQR) observation 2.25 (0.83) h].
Adequate histopathology was obtained in 99% (197/198) of cases. Only one case was determined by a pathologist as not sufficient to render a diagnosis. 84% (166/198) of the biopsies were performed with a 16G needle, and 16% (32/198) were performed with an 18G needle. Overall, seven complications were detected (3.5% of all biopsies, 7/198) in seven patients. All complications detected were minor, 1.5% (3/198) were categorized as SIR A and 2% (4/198) as SIR B. The most common complication included pain after biopsy (4/198), followed by rash at the biopsy site (3/198). No major complications were detected in our sample.
In a consecutive cohort of children, the use of a limited 2 h observation period after an ultrasound-guided percutaneous biopsy was a sufficient monitoring period for complications. Additionally, we did not observe a high proportion of patients returning for follow-up medical care after discharge due to complications.
我们回顾性研究了门诊经皮超声引导下肝活检后2小时的有限观察期对儿童来说是否是足够的监测期。
本研究是一项经机构审查委员会批准的回顾性队列研究，回顾了2014年6月1日至2016年6月30日期间连续进行的门诊经皮超声引导下肝活检。2014年6月1日至2016年6月30日期间，共有192例患者（85名女性和113名男性）接受了198次门诊超声引导下肝活检（年龄范围3周 - 18岁，平均11.6岁）。门诊活检时患者的观察时间有限[观察时间中位数（四分位间距）为2.25（0.83）小时]。
99%（197/198）的病例获得了足够的组织病理学结果。只有1例经病理学家判定不足以做出诊断。84%（166/198）的活检使用16G针，16%（32/198）使用18G针。总体而言，在7名患者中检测到7例并发症（占所有活检的3.5%，7/198）。检测到的所有并发症均为轻微并发症，1.5%（3/198）分类为SIR A级，2%（4/198）为SIR B级。最常见的并发症包括活检后疼痛（4/198），其次是活检部位皮疹（3/198）。我们的样本中未检测到重大并发症。
在连续的儿童队列中，经皮超声引导下活检后使用2小时的有限观察期对并发症来说是足够的监测期。此外，我们没有观察到因并发症出院后返回接受后续医疗护理的患者比例很高。
