[Immediate postoperative color Doppler ultrasonography on the diagnosis of hemorrhagic complications of liver biopsy and its directed compression hemostasis]

Zhonghua Gan Zang Bing Za Zhi. 2022 Mar 20;30(3):285-289. doi: 10.3760/cma.j.cn501113-20200809-00446.
[Article in Chinese]

Abstract

Objective: To study the diagnostic value of immediate color Doppler ultrasonography on traumatic hepatic hemorrhage after tissue sampling with ultrasound-guided liver biopsy and the clinical effect of its-directed local compression hemostasis at puncture-site. Methods: 132 hospitalized patients with various liver diseases underwent ultrasound-guided hepatic puncture-biopsies, including 61 cases with diffuse parenchymal and 71 cases with focal liver lesions. Immediate postoperative color Doppler ultrasonography was performed following liver biopsy. Abnormal blood flow signal was observed at hepatic puncture biopsy site, and if there were hemorrhagic signals, ultrasound-directed local compression hemostasis was performed until the bleeding signal disappeared. F-test and Chi-square test were used for statistical analysis. Results: Immediate color Doppler ultrasonography showed traumatic hemorrhage in 36.1% (22/61) and 40.8% (29/71) cases of diffuse liver disease and focal liver disease group, respectively. All hemorrhagic signals were eventually disappeared after ultrasound-directed local compression hemostasis. The median hemostasis time was 2 min in both groups, and there was no statistically significant difference in bleeding rate and hemostasis time between the two groups (P>0.05). There were no serious complications and deaths. Conclusion: Traumatic hepatic hemorrhage along the needle puncture tract is a common accompanying condition during liver biopsy. Immediate postoperative color Doppler ultrasonography can trace bleeding signals in timely manner and direct effective compression hemostasis, so it should be used routinely to help avoid occurrence of severe hemorrhagic complications.

目的: 研究超声引导下肝活检术中,组织取材后即刻行彩色多普勒超声检查对肝脏损伤性出血的诊断价值,研究超声引导下穿刺点局部压迫止血的临床效果。 方法: 132例各种肝脏疾病住院患者行超声引导下肝穿刺活组织检查,包括61例弥漫性肝实质病变和71例肝脏局灶性病变,于肝活检后即刻行彩色多普勒超声检查,观察穿刺部位的异常血流信号,如有出血性信号则行超声引导下压迫止血,直至出血信号消失。计量资料比较用方差分析,计数资料比较用χ2检验。 结果: 即刻彩色多普勒超声检查显示弥漫性肝病组和局灶性肝病组分别有36.1%(22/61)和40.8%(29/71)的病例出现损伤性出血。进行超声引导下的局部压迫止血,所有的出血信号最终都消失,2组的止血时间中位数均为2 min,2组间出血率和止血时间差异均无统计学意义(P>0.05)。无严重并发症和死亡发生。 结论: 沿穿刺针道的肝脏损伤性出血在肝活检术中是常见的伴随情况,即刻彩色多普勒超声检查能够及时发现出血信号,并引导有效压迫止血,即刻彩色多普勒超声检查应成为肝活检术中取材后的常规措施,可能会有助于避免严重出血并发症的发生。.

MeSH terms

  • Biopsy
  • Hemorrhage / etiology
  • Hemostasis* / physiology
  • Humans
  • Liver / diagnostic imaging
  • Liver / pathology
  • Liver Diseases* / pathology
  • Ultrasonography
  • Ultrasonography, Doppler, Color / adverse effects