两种不同方式经皮肝穿刺活组织检查的优缺点分析

目的探讨一秒钟负压抽吸法和Bard Magnum切割针自动切割法经皮穿刺肝活检的优缺点。方法在3322例次住院肝病患者肝活检中,分别采用抽吸法3059例次和切割法263例次。对抽吸法获取的标本长度小于1.5cm或为碎片组织的病例行2次或3次肝穿刺;切割法为经皮肤上同一针孔、肝内不同部位连续2次以上肝穿刺,即"一孔多点切割法"。结果抽吸法和切割法肝活检第一针穿刺标本平均长度分别为2.06±0.62cm和1.29±0.50cm(t=17.089,P=0.000);在221例抽吸法获得碎片组织的慢性乙型肝炎患者中,病理学诊断为肝硬化者184例(83.26%),对不能诊断为肝硬化的37例患者再行"一孔多点切割法"肝活检,结果35例(94.6%)为肝硬化。结论抽吸法较切割法获取的肝组织多,应作为肝活检的首选方式,肝组织呈碎片标本的慢性乙型肝炎患者大多是肝硬化,"一孔多点切割法"几乎能检出所有的肝硬化患者。

Comparative study of sampling errors of two different percutaneous liver biopsies

Objective To investigate the sampling errors of two different ways of percutaneous liver biopsies. Methods The liver biopsy in 3059 patients were performed by Menghini needle and in 263 patients by automatic Tru- cut needle. Results The average length of samples by Menghini needle were 2.06±0.62cm,longer than by automatic Tru- cut （1.29 ±0.50cm,t =17.089,P =0.000）;In 221 fragmented tissue samples obtained by Menghini,the liver cirrhosis were confirmed in 184 patients（83.26%）;In other 37 patients with fragmented samples without pathological diagnosis at first needle,the second needle by automatic Tru- cut showed liver cirrhosis in 35 patients （94.6%）. Conclusion The samples obtained by Menghini are longer than that by automatic Tru-cut.Nearly all the samples with fragmented tissues by suction needle in patients with hepatitis B are diagnosed as liver cirrhosis.