Transjugular liver biopsy: enlarge the indications for liver biopsy with reliable diagnostic quality.
Transjugular liver biopsy: enlarge the indications for liver biopsy with reliable diagnostic quality.
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DOI：
10.1186/s12876-023-02917-x
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发表时间：
2023-08-14
影响因子：
2.4
通讯作者：
Liu, Du-Xian
中科院分区：
文献类型：
--
作者：
Chen, Miao-Yang;Yang, An-Yin;Hu, Yi-Fan;Yang, Yong-Feng;Xiong, Qing-Fang;Zhong, Yan-Dan;Liu, Du-Xian
肝活检的并发症和诊断效率是临床医生主要关心的问题。本研究旨在使用倾向评分匹配（PSM），评估当患者肝功能水平和通过次数相同时，经颈静脉肝活检（TJLB）与经皮肝活检（PLB）相比的安全性和有效性。收集2012年1月至2022年10月期间接受TJLB或PLB的患者的临床和病理数据。匹配因素包括年龄、性别、肝硬化、门脉高压、肝功能、肌酐、通过次数、血液透析、抗凝和抗血小板治疗史以及合并症。由于两种技术的适应症不同，凝血指标未被视为匹配因素。共评估PLB 2711例，TJLB 30例。通过PSM，75例患者（50例PLB，25例TJLB）匹配。TJLB和PLB的并发症发生率分别为4.0%（1/25）和10.0%（5/50）（P > 0.05）。2例PLB发生肝出血，其中1例仅需密切监测（1级），另1例需要止血和补液治疗（2级）。其他3例病例表现为轻度腹痛（1级）。只有一个TJLB表现出轻微的疼痛。TJLB和PLB的完整汇管区数中位数分别为6.0和10.0（P < 0.05）。TJLB和PLB的样本长度中位数分别为10.0和16.5mm（P < 0.05）。TJLB组与PLB组匹配前后对不明原因肝病的诊断有效率分别为96.4%与94.1%、95.7%与93.2%（P > 0.05）。TJLB是一种有效的侵入性诊断程序，扩大了肝活检的适应症，具有可靠的诊断质量。
Complications and diagnostic efficiency for liver biopsy are main concerns for clinicians. This study aimed to assess the safety and efficacy of transjugular liver biopsy (TJLB) compared with percutaneous liver biopsy (PLB) when patients had equal level of liver function and number of passes, using propensity score matching (PSM). The clinical and pathological data of patients who received TJLB or PLB between January 2012 and October 2022 were collected. Matching factors included age, gender, cirrhosis, portal hypertension, liver function, creatinine, number of passes, hemodialysis, history of anti-coagulation and anti-platelet, and comorbidities. Coagulation indexes were not considered as matching factors due to different indications of the two techniques. 2711 PLBs and 30 TJLBs were evaluated. By PSM, 75 patients (50 PLBs, 25 TJLBs) were matched. The complication rates for TJLB and PLB were 4.0% (1/25) and 10.0% (5/50) (P > 0.05). Two PLBs had hepatic hemorrhage, one of which required only close monitoring (Grade 1) and the other needed hemostasis and rehydration therapy (Grade 2). The other 3 cases presented with mild abdominal pain (Grade 1). And only one TJLB presented with mild pain. The median number of complete portal tracts were 6.0 and 10.0 for TJLBs and PLBs (P < 0.05). Moreover, the median length of sample for TJLBs and PLBs were 10.0 and 16.5 mm (P < 0.05). The diagnostic efficiency of hepatopathy of unknown etiology of TJLB versus PLB groups before and after matching were 96.4% vs. 94.1% and 95.7% vs. 93.2%, respectively (P > 0.05). TJLB is an effective invasive diagnostic procedure that expands indications for liver biopsy with reliable diagnostic quality.
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DOI：
10.1111/jth.15888
发表时间：
2022-12
期刊：
Journal of thrombosis and haemostasis : JTH
影响因子：
--
作者：
通讯作者：
--
影响因子：
35.7
作者：
de Gottardi, Andrea;Rautou, Pierre-Emmanuel;Alonso, Cristina
通讯作者：
Alonso, Cristina
影响因子：
3.6
作者：
Sue, Megan J.;Lee, Edward W.;Kee, Stephen T.
通讯作者：
Kee, Stephen T.
DOI：
10.1590/s1678-9946201658010
发表时间：
2016
影响因子：
1.9
作者：
Coral GP;Antunes AD;Serafini AP;Araujo FB;Mattos AA
通讯作者：
Mattos AA
影响因子：
24.5
作者：
Neuberger, James;Patel, Jai;Heydtmann, Mathis
通讯作者：
Heydtmann, Mathis