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[犬猫超声引导下肝活检的并发症]

[Complications of ultrasound-guided liver biopsies in dogs and cats].

作者信息

Moritz Anne-Kristin, Köhler Claudia, Fromme Vivian, Winter Karsten, Alef Michaele, Kiefer Ingmar

出版信息

Tierarztl Prax Ausg K Kleintiere Heimtiere. 2018 Feb;46(1):5-13. doi: 10.15654/TPK-170183. Epub 2018 Feb 21.

Abstract

OBJECTIVE

Ultrasound-guided biopsies are obtained generally to reach a sound diagnosis in the case of sonographically detectable hepatic changes. The most common and well-known complication associated with ultrasound-guided biopsies is haemorrhage after sampling, which may lead to the patient's death. The aim of this study was to evaluate a possible association between alterations in the coagulation parameters and sonographically observable haemorrhage following liver biopsies.

MATERIALS AND METHODS

Dogs and cats in which an ultrasound-guided biopsy of the liver had been performed were retrospectively enrolled in the study. Inclusion criteria were thoroughly documented sonographic findings and the results of the coagula tion parameter thromboplastin time or a combination of the activated partial thromboplastin time and prothrombin time. The incidence of post-interventional ascites and possible risk factors were evaluated.

RESULTS

A total of 105 patients met the inclusion criteria and the data of 94 dogs (89.5 %) and 11 cats (10.5 %) were analysed. Post-interventional complications occurred in 26 of 105 patients (24.8 %), 21.9 % being minor and 2.9 % being major. Free abdominal fluid after intervention was sonographically detected in 22 of 94 dogs (23.4 %) and four of 11 cats (36.4 %). Three of 10 dogs (2.9 %) with a clinically significant prolongated coagulation time of > 25 % had ascites after biopsy. Only a small amount of fluid was detected in two of these three dogs, while a moderate amount of ascites was observed in the third dog. One of two cats with a prolonged coagulation time of > 25 % developed a moderate amount of ascites after the puncture. No statistically significant association was found between the occurrence of post-interventional ascites and a prolongation of the coagulation time.

CONCLUSION

According to the study results, there is no obvi ous correlation between alterations in coagulation and haemorrhage after an ultrasound-guided liver biopsy.

摘要

目的

在超声可检测到肝脏变化的情况下,通常进行超声引导下活检以做出可靠诊断。与超声引导下活检相关的最常见且广为人知的并发症是取样后出血,这可能导致患者死亡。本研究的目的是评估凝血参数改变与肝活检后超声可观察到的出血之间可能存在的关联。

材料与方法

对接受过超声引导下肝脏活检的犬猫进行回顾性研究。纳入标准为有详尽记录的超声检查结果以及凝血参数凝血酶原时间或活化部分凝血活酶时间与凝血酶原时间组合的结果。评估介入后腹水的发生率及可能的危险因素。

结果

共有105例患者符合纳入标准,分析了94只犬(89.5%)和11只猫(10.5%)的数据。105例患者中有26例(24.8%)发生介入后并发症,其中轻微并发症占21.9%,严重并发症占2.9%。超声检查发现94只犬中有22只(23.4%)、11只猫中有4只(36.4%)在介入后出现腹腔游离液体。10只凝血时间临床显著延长>25%的犬中有3只(2.9%)在活检后出现腹水。这3只犬中有2只仅检测到少量液体,而第3只犬观察到中等量腹水。2只凝血时间延长>25%的猫中有1只在穿刺后出现中等量腹水。介入后腹水的发生与凝血时间延长之间未发现统计学上的显著关联。

结论

根据研究结果,超声引导下肝活检后凝血改变与出血之间无明显相关性。

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