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《彩超引導(dǎo)下經(jīng)皮穿刺活檢對(duì)肝臟病變的診斷及其臨床應(yīng)用價(jià)值-論文.pdf》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在應(yīng)用文檔-天天文庫。
1、;用醫(yī)刊2014年5月第41卷第1O期ChineseJournalofPracticalMedicineMay.2014.V0l_41.N0.10·17·彩超引導(dǎo)下經(jīng)皮穿刺活檢對(duì)肝臟病變的診斷及其臨床應(yīng)用價(jià)值陳中建趙永福【摘要】目的探討與分析彩超引導(dǎo)下經(jīng)皮穿刺活檢對(duì)肝臟病變的診斷及其臨床應(yīng)用價(jià)值。方法選擇2010年1月至2013年1月來鄭州大學(xué)第一附屬醫(yī)院經(jīng)臨床診斷為原發(fā)性肝癌、轉(zhuǎn)移性肝癌門或肝硬化等肝臟占位性病變患者140例為研究對(duì)象,對(duì)其均予以彩超引導(dǎo)下經(jīng)皮穿刺活檢,回顧性分析其臨床資料。結(jié)果140例患者均經(jīng)彩超引導(dǎo)下經(jīng)皮穿刺活檢或手術(shù)病理最后確診,其中
2、惡性腫瘤120例,占85.71%,良性病變2O例,占14.29%。彩超引導(dǎo)下經(jīng)皮穿刺活檢確診惡性腫瘤118例,良性病變18例,活檢未能確診肝癌2例,肝硬化2例。引導(dǎo)下肝穿刺活檢診斷的敏感度高于入院臨床診斷、超聲診斷,經(jīng)比較差異有統(tǒng)計(jì)學(xué)意義(x=20.877,11.772,P=0.000,0.OO1)。引導(dǎo)下肝穿刺活檢診斷的特異度明顯高于入院臨床診斷()(=10.989,P=0.001),與超聲診斷相比差異無統(tǒng)計(jì)學(xué)意義(x=2.500,P=0.114)。引導(dǎo)下肝穿刺活檢診斷的準(zhǔn)確度高于入院臨床診斷、超聲診斷,經(jīng)比較差異有統(tǒng)計(jì)學(xué)意義()(=29.867,13.7
3、37,P:0.000,0.000)。穿刺1次、2次、3次的佳良率分別為100%、93.33%、97.22%,各組的穿刺組織標(biāo)本滿意度比較差異無統(tǒng)計(jì)學(xué)意義(P>0.05)。結(jié)論彩超引導(dǎo)下經(jīng)皮穿刺活檢對(duì)肝臟病變的診斷安全、準(zhǔn)確、微創(chuàng)、簡便,并對(duì)肝臟病變的病理組織學(xué)類型進(jìn)行確定,具有較高的臨床價(jià)值?!娟P(guān)鍵詞】彩超;穿刺活檢;肝臟病變;診斷UltrasoundguidedpercutaneousbiopsyindiagnosisofliverdiseaseanditsclinicalapplicationvalueCHENZhong-jian,ZHAOYong-fu
4、.DepartmentofHepatopancreatobiliarySurgery,the£AffiliatedHospitalofZhengzhouUniversity,Zhengzhou450052,China【Abstract】0bjectiveToinvestigateandanalyzetheultrasoundguidedpercutaneousbiopsyindiagnosisofliverdiseaseanditsclinicalapplicationvalue.MethodsTochose140patientsdiagnosedashep
5、atocellularcarcinoma,metastaticlivercancerorcirrhosisandotherliverspaceoccupyinglesionsbetweenJanuary2010andJanuary2013inthefirstafiliatedhospitalofZhengzhouuniversityasthere—searchobject,theyweretreatedwithultrasoundguidedpereutaneousbiopsy,andtheirclinicaldatawereretrospectivelya
6、nalyzed.ResultsOnehundredandfortypatientsweretreatedbyultrasoundguidedpercutaneouspuncturebiopsyoroperationpathologicallyconfirmedlast,includingmalignantin120cases,accountingfor85.71%,20casesofbenignlesions,accountingfor14.29%.Ultrasoundguidedpercutaneouspuncturebiopsyof118casesofm
7、alignanttumor,18casesofbenignlesions,2casesofbiopsyfailedtodiagnoselivercancer,2casesoflivercirrhosis.Guidedbiopsydiagnosisofliverbiopsysensitivitywashigherthanthatofclinicaldiagnosisonadmission,ultrasounddiagnosis,thedifferencewasstatisticalsignificant(X=20.877,11.772,P=0.000,0.00
8、1).Guidedbiopsyofliverpunc