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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。
Objective To investigate the advantages and disadvantages of one-second vacuum suction and Bard Magnum needle biopsy. Methods In the liver biopsy of 3322 hospitalized patients with liver disease, 3059 cases of suction and 263 cases of incision were performed respectively. The suction method to obtain the specimen length less than 1.5cm or debris tissue cases 2 or 3 times liver puncture; cutting method for the same pinhole through the skin, different parts of the liver more than 2 consecutive liver puncture, that is, “ A multi-point cutting method ”. Results The average length of the first needle aspiration specimens was 2.06 ± 0.62cm and 1.29 ± 0.50cm respectively (p = 0.000, t = 17.089, P = 0.000) In hepatitis patients, pathological diagnosis of cirrhosis in 184 cases (83.26%), 37 cases of patients can not be diagnosed with cirrhosis “multi-point one hole” liver biopsy, the results of 35 cases (94.6% For cirrhosis. Conclusion Aspiration method is more effective than the cutting method to obtain the liver tissue, liver biopsy should be used as the preferred method, the liver tissue fragments of chronic hepatitis B patients are mostly cirrhosis, “one hole multipoint cutting method ” almost can seized Out of all patients with cirrhosis.