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超声引导同轴针穿刺活检联合明胶海绵封堵在小儿肝脏活检中的应用

Application of ultrasound-guided coaxial needle biopsy combined with gelatin sponge plugging in pediatric liver biopsy.

作者信息

Zeng Keyu, Yu Boyang, Wu Zhe, Zhou Jiehong, Lu Qiang

机构信息

Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China.

School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Front Pediatr. 2025 May 20;13:1477711. doi: 10.3389/fped.2025.1477711. eCollection 2025.

Abstract

PURPOSE

The aim of this study was to assess the performance of utilizing the coaxial technique in conjunction with gelatin sponge slurry plugging for ultrasound-guided liver biopsy in children.

METHODS

We conducted a retrospective study of children undergoing ultrasound-guided coaxial liver biopsy at our institution between March 2020 and March 2025. Participants were stratified into two intervention groups: those receiving gelatin sponge tract embolization vs. batroxobin administered through needle tract. Through comprehensive electronic medical record review, we systematically extracted and compared the following outcome measures: (a) overall complication rates, (b) hemorrhage rates.

RESULTS

This study included 48 children, with 30 allocated to the gelatin sponge group and 18 to the batroxobin group. The gelatin sponge group demonstrated 9 complications (30.0%, 9/30), consisting of 5 pain events and 4 febrile episodes, while the batroxobin group experienced 6 complications (33.3%, 6/18), including 2 hemorrhage cases, 3 pain events, and 1 febrile episode. The overall complication rates showed no statistically significant difference between groups (30.0% vs. 33.3%,  = 0.809). However, a significant divergence was observed in hemorrhage incidence, with the gelatin sponge group demonstrating superior safety (0% vs. 11.1%,  = 0.044).

CONCLUSION

Compared to batroxobin tract injection, coaxial technique in conjunction with gelatin sponge slurry plugging significantly reduced hemorrhagic complications in liver biopsies for children, demonstrating superior safety. The finding supported its adoption as the preferred hemostatic method in children undergoing percutaneous liver biopsy.

摘要

目的

本研究旨在评估在儿童超声引导下肝活检中联合使用同轴技术与明胶海绵浆液封堵的效果。

方法

我们对2020年3月至2025年3月在我院接受超声引导下同轴肝活检的儿童进行了一项回顾性研究。参与者被分为两个干预组:接受明胶海绵通道栓塞的组与通过针道注射巴曲酶的组。通过全面的电子病历审查,我们系统地提取并比较了以下结果指标:(a)总体并发症发生率,(b)出血率。

结果

本研究纳入48名儿童,其中30名被分配到明胶海绵组,18名被分配到巴曲酶组。明胶海绵组出现9例并发症(30.0%,9/30),包括5例疼痛事件和4例发热发作,而巴曲酶组出现6例并发症(33.3%,6/18),包括2例出血病例、3例疼痛事件和1例发热发作。两组之间的总体并发症发生率无统计学显著差异(30.0%对33.3%,P = 0.809)。然而,在出血发生率方面观察到显著差异,明胶海绵组显示出更高的安全性(0%对11.1%,P = 0.044)。

结论

与巴曲酶针道注射相比,同轴技术联合明胶海绵浆液封堵在儿童肝活检中显著降低了出血并发症,显示出更高的安全性。这一发现支持将其作为接受经皮肝活检儿童的首选止血方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c675/12129982/12779641b014/fped-13-1477711-g001.jpg

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