B超引导下经皮肝穿刺130例临床分析

目的评价130例肝病患者应用经皮肝穿刺技术的安全性以及该项技术在肝病诊断和治疗中的价值。方法回顾性分析我科自2004年以来接受过B超定位或引导下经皮穿刺诊断和治疗患者情况。共计130例患者列入调查,穿刺后治疗组48例,穿刺后诊断组82例。治疗结果以治疗半年后影像学检查(B超、CT、MRI)为参考,分为完全消除、基本消除和未消除3个等级;将临床诊断和介入性诊断结果进行比较,观察二者诊断的符合率。结果130例患者共进行164点穿刺,穿刺成功率为98.1%,术后无一例发生严重并发症。经皮肝穿刺后介入治疗57个病灶,共进行82次穿刺治疗,总有效率为87.7%。经皮肝穿刺后介入性诊断82例,与临床诊断符合61例,总的诊断符合率为74.4%。结论B超引导下经皮肝穿刺术临床应用广泛、安全,可大大提高肝脏疾病的诊断和治疗水平。

The Clinical analysis of Percutaneous Liver Puncture Under B-Type Ultrasonic guidance

Objective To evaluate the security and the diagnostic or therapeutic value of percutaneous liver puncture under ultrasonic guidance.Methods To analyze retrospectively the 130 surveyed patients who accepted percutaneous liver puncture for diagnostic or therapeutic purpose since 2004.All patients were divided into treatment group and examination group,which had 48 and 82 cases respectively.Therapeutic results were divided into three grades by imaging(ultrasonic,CT,MRI):elimination,sub-elimination and non-elimination.The resultss were evaluated by the concordance rate between clinical diagnosis and interventional diagnosis.Results 130 patients had been punctured in 160 points without any serious complication;the effective rate was 98.1%.57 foci were accepted treatment for 82 times after liver puncture,the total effective rate was 87.7%.In examination group,61 cases complied with the clinical diagnosis.The total concordance rate of diagnosis was 74.4%.Conclusions The clinical application of percutaneous liver puncture under ultrasonic guidance is widespread and secure,and can improve greatly the diagnostic and therapeutic status of liver diseases.