CT引导下经皮肝穿刺活检术在不明原因肝功能异常诊断中的临床应用

Clinical application of CT guided percutaneous liver biopsy in the diagnosis of unexplained liver function abnormality

目的探讨CT引导下经皮肝穿刺活检术在不明原因肝功能异常诊断中的临床应用。方法回顾性分析58例不明原因肝功能异常患者行CT引导下经皮肝穿刺活检术的临床、病理资料,主要观察术后病理诊断率、GS分级诊断率、并发症。结果本组取材成功率100%,手术平均时间11.52 min,取得组织条(1.48±0.50)条,病理诊断率为84.5%(49/58),病理肝炎活动度(G)和肝纤维化程度(S)分级诊断率为72.4%(42/58)。经皮肝穿刺操作未导致肝功能指标数值(ALT、AST、ALP、GGT、TBIL)在短期内显著性增高。8例(13.8%)肝包膜下少量出血,经内科治疗后无进展。结论CT引导下经皮肝穿刺活检术对不明原因肝功能异常的病理及GS分级诊断率高,并发症可控,具有一定的临床应用价值。

Objective To explore the clinical application of CT guided percutaneous liver biopsy in the diagnosis of liver dysfunction abnormality.Methods The clinical and pathological data of 58 patients with unexplained liver function abnormality undergoing CT guided percutaneous liver biopsy were analyzed retrospectively.The postoperative pathological diagnosis rate,GS grading diagnosis rate and complications were observed.Results The success rate of sampling in this study was 100%,and the operation time was 11.52 minites,(1.48±0.50)tissue items were obtained,pathological diagnosis rate was 84.5%(49/58),the diagnosis rate of pathological hepatitis activity(G classification)and liver fibrosis degree(S classification)was 72.4%(42/58).Percutaneous liver puncture did not lead to significant increase in liver function indexes(ALT,AST,ALP,GGT,TBIL)in the short term.8 cases(13.8%)had a small amount of hemorrhage under the capsule of the liver,and no progression was observed after medical treatment.Conclusion CT guided percutaneous liver biopsy has a high diagnostic rate for the pathology and GS classification of unexplained liver function abnormality,low incidence of complications,and certain clinical application value.