超声引导肝活检在儿童肝病诊断中的应用

Study Ultrasound-Guided Liver Biopsy in Children with Liver Disease

目的探讨超声引导下肝穿刺活检术在儿童肝病诊断中的应用。方法将宁夏医科大学总医院儿科收治的行超声引导下肝穿刺活检的10例患儿作为研究对象,取肝组织进行病理检测,观察穿刺成功率、并发症情况、肝脏的炎症及纤维化程度,并进行临床特点分析。结果10例患儿成功穿刺9例,成功率为90%,穿刺成功的患儿均无并发症发生;9例成功穿刺患儿经病理检查明确诊断9例,确诊率为100%,其中急性肝损害3例,最重的炎症程度达3级;非酒精性脂肪肝病2例,均为重度非酒精性脂肪肝炎;糖原累积病1例,肝脏炎症程度为重度;慢性乙型病毒性肝炎3例,血清ALT均正常但有不同程度炎症。结论超声引导下儿童肝穿刺活检的安全性与成功率较高,可推广应用于儿童肝病的诊治。

Objective To study ultrasound-guided liver biopsy in children with liver disease.Methods Ten children who underwent ultrasound-guided liver biopsy in pediatrics of General Hospital of Ningxia Medical University were taken as the research object.The liver tissues were taken for pathological examination,the success rate of puncture,complications,the degree of liver inflammation and fibrosis were observed,and the clinical characteristics were analyzed.Results Nine of 10 children were successfully punctured,and the success rate was 90%,no complications occurred;9 cases were diagnosed by pathological examination,and the diagnostic rate was 100%.Among them,3 cases had acute liver damage,and the most severe inflammation was grade 3.Two cases of nonalcoholic fatty liver disease were severe nonalcoholic steatohepatitis.There was 1 case of glycogen accumulation disease,and the degree of liver inflammation was severe.In 3 cases of chronic hepatitis B,serum ALT was normal,but there were different degrees of inflammation.Conclusion Ultrasound-guided liver biopsy in children has high safety and success rate and low incidence of complications.Its popularization and application can improve the level of diagnosis and treatment of children's liver disease in our area.