不明原因肝功能异常78例肝穿刺活检分析

目的探讨肝穿刺活检对不明原因肝功能异常患者的诊断价值。方法对78例不明原因肝功能异常患者行肝穿刺检查,分析肝脏病理及临床特点。结果病理确诊70例。检出自身免疫性肝病29例(37.2%),药物性肝损伤25例(32.1%),非酒精性脂肪肝11例(14.1%),隐匿性乙型肝炎2例(2.6%),遗传代谢性肝病3例(3.9%)。结论肝穿刺检查对诊断肝病具有重要价值,对不明原因肝功能异常患者建议肝穿刺检查。     

CT引导下经皮肺穿刺活检术的临床应用

CT引导下经皮肺检穿刺活检术对孤立性肺结节的诊断和鉴别诊断提供了可靠的组织细胞学依据。尤其在胸部肿瘤的常规诊断方法如X线检查、痰细胞学及纤维支气管镜检查的局限性和缺点影响下，更显其具有简单、迅速、并发症少等优点，在某些方面可弥补上述检查方法之不足。现就近两年12个病例进行分析，探讨CT引导下经皮肺穿刺术的准确性以及并发症的发生和防治。     

CT引导经皮肺穿刺活检术在肺部肿物中的临床应用

目的探讨CT引导经皮肺穿刺活检术对肺部肿物的诊断价值。方法采用CT引导经皮肺穿刺活检术197例肺部肿物进行穿刺活检,病灶直径2～10 cm（平均4.2 cm）,病灶距胸膜深度0～8cm（平均3.4 cm）。结果诊断恶性病变133例,良性病变（炎症、结核、结节病）54例,诊断率94.9%（187/197）,病理不能确诊10例,其中6例手术确诊为肺鳞癌,4例随访2年无变化。术后并发症气胸28例,胸腔出血2例,咯血6例。结论 CT引导经皮肺活检术是一种安全、诊断率高的诊断方法,尤其适用于距离胸膜较近病灶。     

CT引导下经皮肺穿刺活检术的护理

<正>CT引导下经皮肺穿刺活检术是一种分辨率高、定位精确的微创的诊断方法。临床对肺内不明性质的外周病灶常采用CT引导下经皮肺穿刺活检加以诊断,诊断敏感性达88%~98%,特异性100%~([1]),不仅能对肺内病灶进行定性诊断,还可进行病理分型,为患者的治疗和预后提供重要依据,同时也弥补了纤维支气管镜对周围性病变诊断的不足。CT引导下经皮肺穿刺活检虽然是一种安全可靠的检查方法,     

CT引导下经皮肺穿刺活检在肺部占位病变中的诊断价值

目的探讨CT引导下经皮肺穿刺活检对肺部占位病变的诊断价值。方法CT扫描确定最佳的穿刺点、局麻后CT引导下组织切割针经皮刺入到病灶,切割组织行病理检查。结果56例肺占位病变行CT引导下经皮肺穿刺活检,53例得到确诊,阳性率为94.6%。并发症包括少量气胸11例,肺出血9例,少量咯血5例,均不需特殊处理。结论CT引导下经皮肺穿刺活检对肺占位病变的诊断阳性率高、并发症轻,值得临床推广。     

CT引导下经皮肺穿刺活检29例

20001年12月～2003年12月，我们共进行CT引导下经皮肺穿刺活检29例，现将结果报告如下。     

CT引导下经皮胸腹部穿刺活检术的护理

1　资料与方法1.1　一般资料我院 CT室从 1997年 10月至 2 0 0 0年 10月共施行了 176例 CT引导下经皮胸、腹部穿刺活检术。其中男性 10 8例 ,女性 68例 ,年龄 2 4～ 80岁。1.2　方法1.2 .1　术前准备 :(1)患者准备 :术前做好患者和家属的思想工作 ,帮助他们减少焦虑和恐惧的心理 ,取得合作 ,术前思想工作包括 :解释手术过程、时间 ,描述术前、后所经历的感觉 ;(2 )详细了解病史 ,协助医生做好患者出、凝出时间 ,血小板计数等项检查 ,腹部穿刺须禁食 4小时 ,并对穿刺部位常规清洁 ;(3) CT室术前准备 :除备好穿刺包 (含穿刺针 )外 ,还需准…     

CT引导下经皮肺穿刺活检术114例临床分析

正肺癌是起源于支气管腺体或黏膜的一种恶性肿瘤,世界卫生组织已宣布,在各类恶性肿瘤中,肺癌是导致男性死亡的首要原因,并且在女性死亡原因中也位居第二位[1-2]。目前,肺癌具有高发病率、高复发率及高病死率等特点。因此,每位呼吸病学者应该争取做到早期、快速、准确地诊断肺癌。CT引导下经皮肺穿刺活检术是目前临床广泛应用的辅助手段,它可为临床提供组织病理学依据,既可用于肺内单发和多发的肺结节、肿块、持续性浸润及空洞病灶,也可用于胸膜病变、纵隔和肺门肿块的诊断[2]。我院在CT引导下经皮肺穿刺活检术方面具有丰富经验,为提高临床医生对CT引导下经皮肺穿刺活检术的认识,本文对114例在我院CT引导     

CT引导下经皮肺活检40例临床分析

目的探讨CT引导下经皮肺穿刺活检对肺部周围性病变的诊断价值及安全性。方法 40例肺部周围性病变患者行CT引导下经皮肺穿刺活检术。结果 40例病例中38例得到明确诊断,其中恶性病变25例,良性病变13例,穿刺活检确诊率95%。仅1例出现轻微并发症。结论 CT引导下经皮肺穿刺活检是一种诊断准确性高,安全的检查方法 。     

CT引导经皮肺穿刺活检142例临床分析

目的探讨CT定位下经皮肺穿刺活检的临床应用价值。方法采用意大利普立塞18G（长度10cm;15cm）型弹簧切割式活检针在CT定位下对142例患者行经皮肺穿刺活检术。结果142例均穿刺成功,阳性率96.5%,发生严重气胸1例。结论CT引导下肺穿刺活检对肺部病变确诊率高、并发症少,是一种简便、安全有效、实用的检查方法。     

Endoscopic ultrasound guided liver biopsy for parenchymal liver disease

Liver biopsy plays an essential role in the diagnosis, evaluation and management of a vast proportion of liver diseases. Conventionally, percutaneous and transjugular approaches have been used to obtain liver biopsies. Endoscopic ultrasound guided liver biopsy(EUS-LB) has emerged as a safe and effective alternate in the past two decades. EUS-LB carries a role in evaluation of both benign and malignant diseases of the liver. It can offer higher resolution imaging of the liver and can detect smaller lesions than computed tomography scan of the abdomen or ultrasound scans with the option for doppler assistance to reduce complications. Current evidence demonstrates the superiority of EUS-LB for a targeted approach of focal lesion and there is also evidence of less sampling variability in heterogeneous parenchymal pathologies. These advantages combined with an improved safety profile had led to the rapid progress in the development of new techniques, equipment and procedures for EUS-LB. We provide a comprehensive review of EUS-LB for parenchymal liver disease.     

Endoscopic ultrasound guided liver biopsy: Recent evidence

Liver biopsy(LB) is an essential tool in diagnosing, evaluating and managing various diseases of the liver.As such, histopathological results are critical as they establish or aid in diagnosis, provide information on prognosis, and guide the appropriate selection of medical therapy for patients.Indications for LB include evaluation of persistent elevation of liver chemistries of unclear etiology,diagnosis of chronic liver diseases such as Wilson's disease, autoimmune hepatitis, small duct primary sclerosing cholangitis, work up of fever of unknown origin, amyloidosis and more.Traditionally, methods of acquiring liver tissue have included percutaneous LB(PCLB), transjugular LB(TJLB) or biopsy taken surgically via laparotomy or laparoscopy.However, traditional methods of LB may be inferior to newer methods.Additionally, PCLB and TJLB carry higher risks of adverse events and complications.More recently, endoscopic ultrasound guided LB(EUS-LB) has evolved as an alternative method of tissue sampling that has proven to be safe and effective, with limited adverse events.Compared to PC and TJ routes, EUS-LB may also have a greater diagnostic yield of tissue, be superior for a targeted approach of focal lesions, provide higher quality images and allow for greater patient comfort.These advantages have contributed to the increased use of EUS-LB as a technique for obtaining liver tissue.Herein, we provide a review of the recent evidence of EUS-LB for liver disease.     

CT引导下经皮肺穿刺活检对肺周围性病变的诊断价值

目的评价CT引导下经皮肺穿刺活检对肺周围占位性病变的诊断价值。方法对39例肺周围性病变的患者行CT引导下经皮肺穿刺活检。结果39例中恶性病变29例,良性病变9例,1例因取材少,无病理结果。结论CT引导下经皮肺活检对明确肺周围性病变的性质具有较高的临床实用价值。     

Update on endoscopic ultrasound-guided liver biopsy

Endoscopic ultrasound guided liver biopsy (EUS-LB) has emerged as a minimally-invasive alternative to the traditional (percutaneous or transjugular) liver biopsy techniques for the diagnosis of liver parenchymal diseases. Po-tentially, EUS-LB combines the advantages of percutaneous and transjugular liver biopsy in addressing focused sampling in addition to measuring portal pressure. Additionally, EUS-LB facilitates access to both the lobes of the liver which is not considered with the traditional percutaneous liver biopsy. Multiple studies have compared EUS-LB with conventional liver biopsy and reported comparable diagnostic yield, increased acquisition of complete portal tracts, and longer specimen length as compared to the traditional approaches. EUS-LB is associated with lesser post-procedural pain and shorter recovery time, while providing lower risk of complications when compared to traditional liver biopsy. Innovations in needle types, needle sizes and suction techniques have aimed at further optimizing the EUS-LB technique. This review article updates current literature with focus on the variations in the technique and equipment used for EUS-LB, and compares EUS-LB with traditional methods of liver biopsy.     

CT引导经皮肺穿刺活检的临床评价

目的研究CT引导经皮肺穿刺活检在临床上的应用价值。方法选择2012年9月至2013年10月我院收治的92例肺部出现病灶的患者,采用CT引导经皮肺穿刺活检。结果本组患者经穿刺活检的总确诊率为95．7％（88／92）。穿刺活检气胸发生率为10．9％;肺内血肿发生率为8．7％,咯血发生率为7．6％,胸膜反应发生率为1．1％,肺部感染发生率为1．1％。结论CT引导经皮肺穿刺活检术是一项简单安全、可靠性强、准确性高的临床诊断技术。     

Transjugular liver biopsy: Comparison with percutaneous liver biopsy

Abstract A transjugular liver biopsy was performed on 60 patients. Specimens were successfully obtained from 57 (95%) patients. Specimens obtained from cirrhotic patients were frequently small-sized/fragmented. The wedge hepatic venous pressure and hepatic venous pressure gradient were higher in patients with small-sized/fragmented specimens than those with non-fragmented specimens (16.3 ± 6.4 vs 12.3 ± 4.9 and 10.9 ± 6.2 vs 7.3 ± 3.4 mmHg, P <0.05, respectively). During the same period of time, percutaneous liver biopsies were consecutively performed on 277 patients. The liver specimens by transjugular method were generally smaller (0.63±0.58 vs 1.50±0.86 cm, P <0.001) and more fragmented (63% vs 16%, P <0.01) than those obtained by percutaneous method. Biopsy specimens obtained for diagnosis by the former method were inadequate from 6 (10%) patients and by the latter route were inadequate from 7 (2%) patients. Subcapsular haematoma in one patient was associated with the transjugular liver biopsy. Minor complications occurred in three patients: neck haematoma in two and paroxysmal supraventricular tachycardia during the procedure in one. In comparison, percutaneous liver biopsy was followed by minor complications in 20 patients and major complications in four patients. It is concluded that transjugular liver biopsy is a safe, valuable and alternative procedure to obtain liver specimens, especially in patients who were contraindicated for percutaneous liver biopsy.     

肝组织标本质量与病理学诊断的关系

肝脏的病理学检查对慢性肝病的诊断、治疗、病情的判断及预后的估计有重要意义.为了探讨肝组织标本质量与病理诊断的关系,我们依照我院病理科由2007年6月-2010年1月440例慢性肝病患者肝组织标本的诊断结果作一个相关的回顾性分析.     

CT引导下经皮肺活检的临床应用

目的探讨CT引导下经皮肺穿刺活检对肺部周围型病变的诊断价值。方法对痰细胞学阴性及纤维支气管镜不能确诊的58例肺部周围型病变患者,在胸部CT定位下,用活检针经皮肺穿刺活检取材,行病理学诊断。结果58例患者的诊断阳性率为94．8％（55／58）,阴性率5．2％（3／58）,术后气胸7例,小量咯血2例。结论CT引导下经皮肺穿刺活检是一种安全的检查手段,对周围型肺部病变具有较高的诊断价值。     

肝穿刺活组织病理检查在肝病诊治中的意义

目的评价肝穿刺活组织检查在肝病诊断及治疗中的价值。方法回顾性分析浦东新区南华医院自2007年以来接受B超定位下行1秒钟(1s)肝穿刺诊断并指导治疗患者的情况。结果 16例不明原因肝损伤的患者经肝穿刺活组织检查明确诊断,药物性肝炎4例(4/16,25%),脂肪性肝炎4例(4/16,25%)自身免疫性肝炎2例(2/16,12.5%),乙型肝炎2例(2/16,12.5%),急性淤胆型肝炎、血吸虫性肝病各1例,2例经肝穿活检仍未能明确诊断。在20例反复肝功能异常半年以上、ALT<2倍正常上限值(2×ULN)、高病毒载量的慢性乙型肝炎(CHB)患者中,有65%(13/20)肝脏炎症指数≥2级,需抗病毒治疗,且年龄20～40岁者占69.2%(9/13)。结论肝穿刺活检是诊断肝功能异常病因的重要手段,对明确诊断并确立最适当的治疗方案有重要价值。