影像引导下经皮肝穿刺活检：腹水对并发症发生率的影响。
Image-guided percutaneous hepatic biopsy: effect of ascites on the complication rate.
作者信息
Little A F, Ferris J V, Dodd G D, Baron R L
机构信息
Department of Radiology, University of Pittsburgh Medical Center, PA 15213, USA.
出版信息
Radiology. 1996 Apr;199(1):79-83. doi: 10.1148/radiology.199.1.8633176.
PURPOSE
To determine if image-guided percutaneous hepatic biopsy is contraindicated in patients with ascites.
MATERIALS AND METHODS
The records of 476 patients (173 with ascites and 303 without) who underwent image-guided hepatic biopsy were reviewed retrospectively for number of passes, type of needle, and indications. Coagulopathy was corrected with appropriate blood products before biopsy. Complications were classified as minor (decrease in hematocrit value not necessitating treatment) of major (bleeding that necessitated transfusion or surgery or resulted in death).
RESULTS
Major complications occurred in six patients with ascites and 10 without. Minor complications occurred in 10 patients with ascites and 15 without. With ascites, all major complications necessitated blood transfusions but not surgery. Five patients with major complications had a documented moderate or severe amount of perihepatic ascites. without ascites, nine of the 10 patients required blood transfusions and one required surgery. No deaths occurred in either group.
CONCLUSION
Perihepatic ascites does not statistically significantly affect the major of minor complication rate of image-guided percutaneous hepatic biopsy.
目的
确定对于有腹水的患者，影像引导下经皮肝穿刺活检是否为禁忌。
材料与方法
回顾性分析476例行影像引导下肝穿刺活检患者（173例有腹水，303例无腹水）的穿刺次数、穿刺针类型及适应证。活检前用适当的血液制品纠正凝血功能障碍。并发症分为轻微（血细胞比容值下降但无需治疗）和严重（出血需输血或手术或导致死亡）。
结果
6例有腹水患者和10例无腹水患者发生严重并发症。10例有腹水患者和15例无腹水患者发生轻微并发症。有腹水时，所有严重并发症均需输血，但无需手术。5例发生严重并发症的患者记录有中度或大量肝周腹水。无腹水时，10例患者中有9例需输血，1例需手术。两组均无死亡病例。
结论
肝周腹水对影像引导下经皮肝穿刺活检的严重或轻微并发症发生率无统计学显著影响。
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