超声引导下经皮肝穿刺活检220例临床分析

摘要

Objective To discuss the histopathological characteristics of liver biopsy, and to analyze the distribution of diseases and explore the significance of this percutaneous biopsy in clinical diagnose. Methods A retrospective analysis was made in pathological section samples of 220 cases which were obtained by ultrasound - guided percutaneous liver biopsy in recent 2 years. The distribution of disease in the clinical and pathological diagnosis was summarized. Results The biopsy was successfully performed in all the cases, and no complication occurred. Among the cases of liver space - occupying, 63. 9 % was diagnosed as malignant tumor, most of which was hepatic cellular cancer. Among the ones with HBV - DNA > 10 copies/ml and slight increase of aminopherae, the activity of inflammation in 41. 5% ones was larger than Grade 2,and those patients needed to receive the antiviral therapy. Twenty three cases with unexplained liver function damage were finally diagnosed by liver biopsy. Conclusion Ultrasound - guided percutaneous liver biopsy is a safe and important supplementary method for the diagnosis of liver diseases.%目的 讨论肝穿活检病理组织学特点,分析肝穿病检结果中疾病分布情况,研究肝穿活检对临床诊断的参考意义.方法 对本院近2年各科室送检的220例超声引导下肝脏穿刺活检病理切片标本进行回顾性分析,总结其临床诊断和病理诊断的疾病分布情况.结果 所有病例均成功穿刺,无并发症发生.因肝脏占位送检病例中,有63.9%为恶性肿瘤,且以肝细胞癌为主;因HBV-DNA＞104拷贝/ml、转氨酶轻度升高而送检的慢性乙肝患者中,有41.5%炎症活动度大于2级,需接受抗病毒治疗;23例不明原因肝损害者经肝穿刺活检均明确病因.结论 超声引导下肝脏穿刺活检安全性高,是肝脏疾病诊断的重要辅助手段.