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[肝活检的风险]

[The risk of liver biopsy].

作者信息

Glaser J, Pausch J

机构信息

Abteilung für Allgemeine Innere Medizin und Gastroenterologie, Herz-Jesu-Krankenhaus Fulda.

出版信息

Z Gastroenterol. 1995 Nov;33(11):673-6.

PMID:8600665
Abstract

Complications have been reported to occur in 0.14 through 0.29% of all patients undergoing liver biopsy. The total incidence of complications is lower in laparoscopically guided biopsy when compared with percutaneous liver biopsy. On the other hand fatal complications appear to be more frequent with laparoscopy (0.038%) than with percutaneous biopsy (0.009-0.017%). Nevertheless, laparoscopic biopsy should be preferred particularly in patients with suspected liver cirrhosis, since laparoscopy is more sensitive for this diagnosis. Until now, the significance of the type of biopsy needle used has not definitively been clarified. The results that are available however indicate, that biopsy with the Tru-cut needle is accompanied by a particularly high bleeding risk. Regarding the results of retrospective studies concerning needle diameter, less serious complications appear to occur after fine needle biopsy when compared with standard needles. Thus, fine needle biopsy should be preferred in patients with focal liver lesions, since the bleeding risk is assumed to be higher in these cases.

摘要

据报道,在所有接受肝活检的患者中,并发症发生率为0.14%至0.29%。与经皮肝活检相比,腹腔镜引导下活检的并发症总发生率较低。另一方面,腹腔镜检查的致命并发症似乎比经皮活检更常见(0.038%)(经皮活检为0.009 - 0.017%)。然而,腹腔镜活检应特别适用于疑似肝硬化的患者,因为腹腔镜检查对该诊断更敏感。到目前为止,所用活检针类型的意义尚未明确阐明。然而,现有的结果表明,使用Tru - cut针进行活检时出血风险特别高。关于针直径的回顾性研究结果显示,与标准针相比,细针活检后出现的并发症不太严重。因此,对于局灶性肝病变患者,应首选细针活检,因为在这些情况下出血风险被认为更高。

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