Giger A, Reichen J
Institut für Klinische Pharmakologie, Universität Bern.
Schweiz Med Wochenschr. 1993 Jul 31;123(30):1474-81.
In this retrospective analysis we investigated the diagnostic yield of 148 consecutive liver biopsies performed as an outpatient procedure. In 144 patients, adequate specimens for histologic analysis were obtained. In these patients, 226 diagnoses were entertained. Clinical diagnosis was confirmed in 49.3%, modified in 43.8% and altered in 6.9%. Liver biopsy was particularly helpful in patients where an alcoholic etiology was suspected, since this could be confirmed in only 59.4% while in the others different, often treatable, causes of chronic liver disease were found. Neither conventional nor quantitative liver tests (galactose elimination capacity, aminopyrine breath test) served to differentiate reliably between severe and mild lesions. We conclude that liver biopsy remains an important diagnostic tool in patients with chronic liver disease, and that it can be safely performed on an outpatient basis in appropriately selected patients.
在这项回顾性分析中，我们调查了148例连续进行的门诊肝活检的诊断结果。144例患者获得了用于组织学分析的足够标本。在这些患者中，考虑了226种诊断。临床诊断得到确认的占49.3%，修改的占43.8%，改变的占6.9%。肝活检对怀疑有酒精性病因的患者特别有帮助，因为仅59.4%的患者能确诊，而在其他患者中发现了不同的、通常可治疗的慢性肝病病因。传统的或定量的肝功能检查（半乳糖清除能力、氨基比林呼气试验）均不能可靠地区分严重和轻度病变。我们得出结论，肝活检仍然是慢性肝病患者的重要诊断工具，并且在适当选择的患者中可以在门诊安全地进行。
