Caturelli E, Giacobbe A, Facciorusso D, Bisceglia M, Villani M R, Siena D A, Fusilli S, Squillante M M, Andriulli A
Divisione di Gastroenterologia, Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Foggia, Italy.
Am J Gastroenterol. 1996 Jul;91(7):1318-21.
To evaluate the usefulness of routine ultrasound assessment of puncture site before performing percutaneous biopsy in diffuse liver disease. Seven hundred fifty-three consecutive patients were studied retrospectively.
Serial scanning of the last intercostal spaces allowed us to establish the most suitable access to the thicker liver parenchyma (assessing the most favorable angulation of the needle too), avoiding the puncture of adjacent organs; no more than 1 min was necessary for such a determination.
In 99.4% of patients, a definitive or indicative pathological diagnosis of chronic liver disease was obtained. Only one hemorrhagic complication (0.13%) occurred, requiring no surgical treatment or blood transfusion. Three cases of vasovagal reaction occurred (0.40%): two of these recovered spontaneously, while the other one needed i.v. administration of atropine. Mortality was 0 in our series.
Routine ultrasound of the puncture site is a quick method of assessment, allowing one to increase the diagnostic yield of percutaneous liver biopsy and to maintain low complication rates for such a procedure.
评估在弥漫性肝病患者进行经皮肝穿刺活检前，常规超声评估穿刺部位的实用性。对753例连续患者进行回顾性研究。
对最后肋间间隙进行系列扫描，使我们能够确定进入较厚肝实质的最合适路径（同时评估针的最有利角度），避免穿刺相邻器官；做出这样的判定所需时间不超过1分钟。
99.4%的患者获得了慢性肝病的确切或指示性病理诊断。仅发生1例出血并发症（0.13%），无需手术治疗或输血。发生3例血管迷走神经反应（0.40%）：其中2例自发恢复，另1例需要静脉注射阿托品。本系列研究中死亡率为0。
穿刺部位的常规超声检查是一种快速评估方法，可提高经皮肝穿刺活检的诊断率，并使该操作的并发症发生率保持在较低水平。
