肝穿刺活检对肝硬化诊疗的意义

Significance of Liver Biopsy in Diagnosis and Treatment of Liver Cirrhosis

目的探索肝穿刺活检对肝硬化诊断的意义。方法对2012年9月至2013年10月我院收治的126例疑似肝硬化患者进行B超检查,采取B超定位,组织切割针获取肝脏标本,进行细胞学及病理组织检查。比较病理诊断结果与临床诊断结果的检出率并观察肝穿刺活检术后不良反应发生情况。结果 126例疑似患者中,67例确诊为肝硬化患者,其中临床诊断为失代偿期肝硬化患者27例(40.30%),病理诊断为失代偿期肝硬化患者29例(43.28%),两者对比差异无统计学意义(P>0.05);临床诊断为代偿期肝硬化患者31例(46.27%),病理诊断为代偿期肝硬化患者32例(47.76%),两者对比差异无统计学意义(P>0.05);临床诊断为肝硬化患者58例(86.57%),病理诊断为肝硬化患者61例(91.24%),两者对比差异无统计学意义(P>0.05)。肝穿刺活检术术后局部疼痛14例(20.90%),血压一过性下降5例(7.46%),局部过敏3例(4.48%),局部轻度红肿1例(1.49%)。结论肝穿刺活检对肝硬化诊断符合率高,不良反应少,适应性好,值得临床上广泛应用。

Objective To explore the significance of liver biopsy in diagnosis and treatment of liver cirrhosis. Methods 126 cases of patients with suspected liver cirrhosis treated in our hospital from September 2012 to October 2013 were selected and given B-ultrasonic examination, all the patients were taken B ultrasound localization, and liver specimens of them were achieved by tissue cutting needle and conducted cytological and histological examination. The detection rate of pathological diagnosis and clinical diagnosis were compared and postoperation adverse reactions of liver biopsy were observed. Results Among 126 suspected patients, 67 cases were diagnosed with liver cirrhosis. 27 cases （40.30%） of patients with decompensated liver cirrhosis were diagnosed by clinical diagnosis, 29 cases （43.28%） of patients with decompensated liver cirrhosis were diagnosed by pathological diagnosis, the difference of two methods was not statistical （P 〉0.05）; 31 cases （46.27%） of patients with compensated liver cirrhosis were confirmed by clinical diagnosis, 32 cases （47.76%） of patients with compensated liver cirrhosis were confirmed by pathological diagnosis, the difference of two methods was not statistical （P〉0.05）; 58 cases （86.57%） liver cirrhosis patients were confirmed by clinical diagnosis, 61 cases （91.24%） of liver cirrhosis patients were confirmed by pathological diagnosis, the difference of two methods was not statistical （P 〉0.05）. Postoperative local pain of the liver biopsy was 14 cases （20.90%）, transient blood pressure was 5 cases （7.46%）, local allergy was 3 cases （4.48%）, local mild red and swollen was one case （1.49%）. Conclusions Liver biopsy has high accuracy rate in the diagnosis of liver cirrhosis with few adverse reactions and good adaptability, which is worthy of wide clinical application.