超声引导下经皮穿刺活检肝脏局灶性病变并发症的影响因素

Influencing factors of complications in ultrasound-guided percutaneous biopsy of focal liver lesions

目的探讨超声引导下经皮穿刺活检肝脏局灶性病变并发症的影响因素。方法回顾性分析我院248例行超声引导下经皮肝穿刺活检术的肝脏局灶性病变患者临床及影像学资料,采用单因素和多因素Logistic回归分析患者相关因素(年龄、性别)、病灶相关因素(病灶病位、大小、有无坏死、病灶性质)、操作相关因素(穿刺次数)对穿刺活检并发症发生的影响。结果所有患者穿刺取材成功率为100%,穿刺诊断准确率为94.8%(235/248),穿刺后并发症发生率为11.3%(28/248),其中疼痛占6.9%(17/248),出血占4.0%(10/248);肝脏局灶性病变大小和穿刺次数对并发症发生均有影响(均P<0.05);肝脏局灶性病变穿刺次数为并发症发生的危险因素(β=1.547),肝脏局灶性病变大小为并发症发生的保护因素(β=-1.097)。结论超声引导下经皮穿刺活检肝局灶性病变并发症发生率低;肝脏局灶性病灶大小和穿刺次数是其独立影响因素,其中穿刺次数为危险因素,病灶大小为保护因素。

ObjectiveTo investigate the influencing factors of complications in ultrasound-guided percutaneousbiopsy of focal liver lesions.MethodsAll of 248 patients underwent ultrasound-guided percutaneous liver biopsy were enrolled.The univariate and multivariate Logistic retrospective analysis were performed to study the influence of the patient-related factors(sex,age),lesion-related factors(lesion size,location,pathological type,with or without necrosis),and procedure-related factors(number of puncture)on the incidence of complications by ultrasound-guided.ResultsPuncture was all succeed in all 248 cases.The diagnostic accuracy rate of ultrasound-guided percutaneous biopsy was 94.8%(235/248),the complication rate was11.3%(28/248),among which the frequency of pain was 6.9%(17/248),hemorrhage was 4.0%(10/248).The single factoranalysis showed that the size of the focal liver lesion,number of puncture could influence the incidence of complications(bothP<0.05).The multi-factor analysis showed that the umber of puncture was a risk factor(β=1.547),while the size of the focal liverlesion was a protective factor(β=-1.097).ConclusionThe number of puncture and the size of the focal liver lesion areindependent factors that effect the incidence of complications in ultrasound-guided percutaneous biopsy of focal liver lesions.The number of puncture is a risk factor,while the size of the focal liver lesion is a protective factor.