Complication rate of percutaneous liver biopsies among persons with advanced chronic liver disease in the HALT-C trial.
Complication rate of percutaneous liver biopsies among persons with advanced chronic liver disease in the HALT-C trial.
复制标题
DOI：
10.1016/j.cgh.2010.03.025
复制
发表时间：
2010-10
影响因子：
12.6
通讯作者：
Dienstag, Jules L.
中科院分区：
文献类型：
--
作者：
Seeff, Leonard B.;Everson, Gregory T.;Morgan, Timothy R.;Curto, Teresa M.;Lee, William M.;Ghany, Marc G.;Shiffman, Mitchell L.;Fontana, Robert J.;Di Bisceglie, Adrian M.;Bonkovsky, Herbert L.;Dienstag, Jules L.
尽管经皮肝活检是一种标准的诊断程序，但它也有缺点，包括有严重并发症的风险。目前尚不清楚晚期慢性肝病患者是否比较轻的慢性肝病患者有更高的肝活检并发症风险。对参加丙型肝炎病毒抗病毒长期治疗(HALT-C)试验的丙型肝炎相关桥接性纤维化或肝硬变的患者进行了肝活检的安全性和并发症检查。对2000年至2006年间在10个研究地点进行的2740例肝活检的标准病例报告表进行了审查，以了解严重不良事件，以及调查人员填写的关于每家医院使用的活组织检查技术细节的问卷信息。严重不良反应29例(1.1%)，最常见的是出血(16例，0.6%)。没有与活检相关的死亡。血小板计数为≤60,000/mm~3的患者和国际标准化比率(≥)为1.3的患者的出血率较高，尽管INR>；1.5的患者中没有一例出血。排除血小板计数≤为60,000/mm~3的受试者，出血率将降低25%(4/16)，仅消除2.8%(77/2740)的活检。操作员的经验、使用的针的类型或超声引导下活检的性能不影响不良事件的发生频率。大约0.5%的丙型肝炎和晚期纤维化患者在肝活检后可能发生严重出血；血小板计数为≤60,000/mm~3的患者风险显著增加。(K2)
Although percutaneous liver biopsy is a standard diagnostic procedure, it has drawbacks, including risk of serious complications. It is not known whether persons with advanced chronic liver disease have a greater risk of complications from liver biopsy than patients with more mild, chronic liver disease. The safety and complications of liver biopsy were examined in patients with hepatitis C-related bridging fibrosis or cirrhosis that were enrolled in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) Trial. Standard case report forms from 2,740 liver biopsies performed at 10 study sites between 2000 and 2006 were reviewed for serious adverse events, along with information from questionnaires completed by investigators about details of biopsy techniques used at each hospital. There were 29 serious adverse events (1.1%); the most common was bleeding (16 cases, 0.6%). There were no biopsy-related deaths. The bleeding rate was higher among patients with platelet counts ≤60,000/mm3 and among those with an international normalized ratio (INR) ≥1.3, although none of the patients with an INR >1.5 bled. Excluding subjects with a platelet count ≤60,000/mm3 would have reduced the bleeding rate by 25% (4/16), eliminating only 2.8% (77/2740) of biopsies. Operator experience, the type of needle used, or the performance of the biopsy under ultrasound guidance did not influence the frequencies of adverse events. Approximately 0.5% of persons with hepatitis C and advanced fibrosis experienced potentially serious bleeding after liver biopsy; risk increased significantly in patients with platelet counts ≤60,000/mm3.(K2).
登录
查看更多内容
影响因子：
29.4
作者：
OLYNYK, JK;REDDY, KR;BACON, BR
通讯作者：
BACON, BR
影响因子：
29.4
作者：
MCGILL, DB;RAKELA, J;OTT, BJ
通讯作者：
OTT, BJ
影响因子：
9.8
作者：
Regev, A;Berho, M;Schiff, ER
通讯作者：
Schiff, ER
DOI：
10.1016/j.cct.2004.08.003
发表时间：
2004-10-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
Lee, WM;Dienstag, JL;Everhart, JE
通讯作者：
Everhart, JE
影响因子：
13.5
作者：
Dienstag, JL
通讯作者：
Dienstag, JL