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CT 引导下经皮肝活检中应用明胶海绵浆封堵活检道进行出血管理。

Bleeding management in computed tomography-guided liver biopsies by biopsy tract plugging with gelatin sponge slurry.

机构信息

Department of Radiology, Johanniter-Hospital Bonn, Bonn, Germany.

Department of Radiology, University Hospital Bonn, Bonn, Germany.

出版信息

Sci Rep. 2021 Dec 30;11(1):24506. doi: 10.1038/s41598-021-04155-1.

Abstract

To evaluate the safety and impact of biopsy tract plugging with gelatin sponge slurry in percutaneous liver biopsy. 300 consecutive patients (158 females, 142 males; median age, 63 years) who underwent computed tomography-guided core biopsy of the liver in coaxial technique (16/18 Gauge) with and without biopsy tract plugging were retrospectively reviewed (January 2013 to May 2018). Complications were rated according to the common criteria for adverse events (NCI-CTCAE). The study cohort was dichotomized into a plugged (71%; n = 214) and an unplugged (29%; n = 86) biopsy tract group. Biopsy tract plugging with gelatin sponge slurry was technically successful in all cases. Major bleeding events were only observed in the unplugged group (0.7%; n = 2), whereas minor bleedings (4.3%) were observed in both groups (plugged, 3.6%, n = 11; unplugged, 0.7%, n = 2). Analysis of biopsies and adverse events showed a significant association between number of needle-passes and overall (P = 0.038; odds ratio: 1.395) as well as minor bleeding events (P = 0.020; odds ratio: 1.501). No complications associated with gelatin sponge slurry were observed. Biopsy tract plugging with gelatin sponge slurry is a technically easy and safe procedure that can prevent major bleeding events following liver biopsy.

摘要

评估经皮肝活检中使用明胶海绵浆进行活检道填塞的安全性和影响。回顾性分析了 2013 年 1 月至 2018 年 5 月期间,300 例连续接受同轴技术(16/18 号针)经 CT 引导下肝芯活检的患者(158 例女性,142 例男性;中位年龄 63 岁),其中 71%(n=214)的患者进行了活检道填塞,29%(n=86)的患者未进行活检道填塞。根据不良事件的常见标准(NCI-CTCAE)对并发症进行评分。研究队列分为填塞(71%;n=214)和未填塞(29%;n=86)活检道组。明胶海绵浆的活检道填塞在所有病例中均成功实施。仅在未填塞组观察到主要出血事件(0.7%;n=2),而两组均观察到轻微出血(4.3%)(填塞组 3.6%,n=11;未填塞组 0.7%,n=2)。活检和不良事件分析显示,针道数量与总体(P=0.038;优势比:1.395)以及轻微出血事件(P=0.020;优势比:1.501)之间存在显著相关性。未观察到与明胶海绵浆相关的并发症。明胶海绵浆进行活检道填塞是一种技术上简单且安全的方法,可预防肝活检后发生主要出血事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f3a/8718535/21cc61e34212/41598_2021_4155_Fig1_HTML.jpg

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