同轴针技术辅助凝血功能异常患者经皮肝脏穿刺活检:一项多中心研究

Coaxial needle technique assisted percutaneous liver biopsy in patients with coagulation function abnormalities:a multicenter study

目的探究应用同轴针穿刺技术对于凝血功能异常的患者在经皮肝脏穿刺活检中的有效性和安全性。方法回顾性收集2018年12月至2021年5月在三个中心超声引导下采用同轴针技术行经皮肝脏穿刺活检210例患者的临床资料,分析凝血功能异常组和凝血功能正常组间的穿刺成功率、取样次数、病理合格率、穿刺术中出血及术后出血发生率等指标,并进行组间比较。结果经倾向性评分匹配后,两组各有105例患者,穿刺成功率均为100%,所有样本的病理合格率均为100%。两组术中出血分别为78例(74.3%,78/105)和64例(61.0%,64/105),两组间差异有统计学意义(P=0.006)。术后出血两组分别有3例(2.9%,3/105)和0例,两组间差异无统计学意义(P=0.081)。结论对于凝血功能异常患者,采用同轴针技术进行经皮肝脏穿刺活检,在获取适量组织标本的同时具有良好的安全性。

Objective To investigate the effectiveness and safety of the coaxial needle technique in percutaneous liver biopsy for patients with coagulation function abnormalities.Methods Clinical data of 210 patients who underwent percutaneous liver biopsy using the coaxial needle technique under ultrasound guidance from December 2018 to May 2021 in 3 centers were collected.A retrospective analysis was conducted to compare the puncture success rate,number of samples obtained,pathology qualification rate,intraoperative and postoperative bleeding rates between the group with coagulation function abnormalities and the group with normal coagulation function.Results After propensity score matching,there were 105 patients in each group,with a puncture success rate of 100%in both groups.The pathology qualification rate was 100%for all samples.Intraoperative bleeding occurred in 78 cases(74.3%,78/105)in the coagulation function abnormalities group and in 64 cases(61.0%,64/105)in the normal coagulation function group,with a statistically significant difference between the two groups(P=0.006).Postoperative bleeding occurred in 3 cases(2.9%,3/105)in the coagulation function abnormalities group and in 0 case in the normal coagulation function group,with no statistically significant difference between the two groups(P=0.081).Conclusions The use of the coaxial needle technique for percutaneous liver biopsy in patients with coagulation function abnormalities not only allows for obtaining an adequate tissue sample but also demonstrates good safety.