超声声触诊组织量化技术联合凝血功能指标对肝穿刺活检的安全和准确性的影响

Ultra Sound Touch Organization Quantitative Technique Combined Coagulant Function Indexes Affect the Safety and Accuracy of Liver Biopsy

目的比较分析肝纤维化患者穿刺前VTQ值和凝血功能指标,与肝纤维程度与穿刺后出血发生相关性,探讨VTQ联合凝血功能指标对肝穿安全和准确性的影响。方法收集肝纤维化患者凝血功能相关指标,肝脏VTQ值,肝纤维化程度和穿刺后出血情况。结果 VTQ与纤维化程度相关:肝纤维化患者VTQ值高于正常健康人,纤维化程度加重VTQ值逐渐增大(除S0与S1无差异外),同级纤维化程度患者的肝穿不同部位的VTQ值无差异。穿刺后出血与凝血指标PLT、FIB、PT、TT相关,而出血患者的PLT、FIB、PT与纤维化程度相关。出血的发生排除操作误差以外,与部位无关。结论 VTQ对肝纤维化有定性和量化功能,凝血功能在穿刺后出血患者和未出血患者之间的差异性表达,提示VTQ联合凝血功能指标可能对穿刺技术安全性和准确性提高有重要帮助。

Objective Comparing and analyzing the relationship between VTQ values and coagulation function before puncture,and the degree of fibrosis and the abnormal bleeding after puncture,explored the safety and accuracy for liver biopsy which the combination of VTQ and index of coagulant function applied. Methods Collected VTQ of the different sites of liver,the index of coagulation function,the grade of liver fibrosis,bleeding after liver biopsy. Results The VTQ of liver fibrosis were signifi-cantlyhigher thanhealthy people,the different sites of puncture was detected that no difference of VTQ in same degree of fibrosis in patients. But,the gradually increasing of VTQ was found in liver which fibrosis became gradually worse,excluding S0 and S1. The PLT,FIB,PT,TT was statistically difference between bleeding and not bleeding after liver biopsy in liver fibrosis. Further analyze was developed,the difference of PLT,FIB,PT was discovered in degree of fibrosis in patients with bleeding. Excluding err opera-tion,different parts of liver biopsy appeared no differences in patients with bleeding. Conclusion The combination of accurate qualitative and quantitative function of VTQ and the risk prediction of coagulation function for bleeding in patients after puncture may improve safety and accuracy in liver biopsy.