Ewe K
Dig Dis Sci. 1981 May;26(5):388-93. doi: 10.1007/BF01313579.
Contraindications for percutaneous liver biopsy are often derived arbitrarily from coagulation status of peripheral blood, but no objective data are available on the duration of bleeding from the site of liver biopsy. "Liver bleeding time" (LBT) was measured after liver biopsy had been performed at laparoscopy in 200 consecutive patients using a 1.8-mm-diameter Menghini needle. LBT was then analyzed in relation to prothrombin time, platelet count, whole blood clot time, length of biopsy cylinder, and liver histopathology. There was no correlation among any of these variables. The average LBT was 4 min 37 sec +/- 3 min 48 sec (SD). In 10 patients LBT was prolonged over 12 min (mean +/- 2 SD), but their clotting indices were not different from those of other patients. Bleeding could be stopped easily by compression if necessary. This lack of correlation may be explained by the high concentration of clotting factors in hepatic parenchyma and by mechanical compression of the needle track by the elastic tissue in the liver. It is concluded that indices of coagulation in the peripheral blood used in this study are unreliable guides of the risk of bleeding after liver biopsy and, hence, are of limited value in determining contraindications to this procedure.
经皮肝穿刺活检的禁忌证通常是根据外周血凝血状态随意确定的，但关于肝穿刺活检部位的出血持续时间，尚无客观数据。在200例连续患者中，使用直径1.8毫米的Menghini针在腹腔镜下进行肝穿刺活检后，测量了“肝出血时间”（LBT）。然后分析LBT与凝血酶原时间、血小板计数、全血凝固时间、活检组织块长度以及肝脏组织病理学的关系。这些变量之间均无相关性。LBT的平均时间为4分37秒±3分48秒（标准差）。10例患者的LBT延长超过12分钟（平均值±2标准差），但其凝血指标与其他患者并无差异。如有必要，通过压迫可轻松止血。这种缺乏相关性的情况可能是由于肝实质中凝血因子浓度较高以及肝脏弹性组织对针道的机械压迫所致。结论是，本研究中使用的外周血凝血指标不能可靠地指导肝穿刺活检后的出血风险，因此，在确定该操作的禁忌证方面价值有限。
