Abstract:

Objective　To study the characteristics of ultrasound-guided liver biopsy in non-viral liver diseases. Methods　The clinical data of 83 patients with non-viral liver diseases admitted to Huangshi Central Hospital from July 2021 to July 2022 were retrospectively analyzed, including 37 males and 46 females, aged (57.79±9.08) years. All the patients received blood routine and electrocardiogram examinations after admission (before treatment), and were instructed by nursing staff to perform breath-holding and expiratory training. Liver biopsy was performed under ultrasound guidance. The complications and results of ultrasound guided liver biopsy and its coincidence rate with clinical diagnosis were observed. Results　All the 83 patients with non-viral liver diseases successfully completed liver biopsy, and their vital signs were basically normal after liver biopsy, among whom 55.42% (46/83) had slight pain at the puncture site, and 4.82% (4/83) of chest tightness and 3.61% (3/83) of blood pressure decreased after puncture. Of the 83 patients, 93.98% (78/83) were confirmed by liver biopsy. Among them, 51.81% (43/83) were autoimmune liver disease, 18.07% (15/83) of non-alcoholic fatty liver disease, 14.46% (12/83) of alcoholic liver disease, 4.82% (4/83) of drug-induced liver injury, 3.61% (3/83) of liver vascular disease, and 1.20% (1/83) of neoplastic disease, and another 6.02% (5/83) failed to identify the cause. The coincidence rates of the above 6 diseases diagnosed by ultrasound-guided liver biopsy with clinical diagnosis were 93.48% (43/46), 100.00% (15/15), 92.31% (12/13), 100.00% (4/4), 100.00% (3/3), and 50.00% (1/2), with the overall coincidence rate of 93.98% (78/83). Conclusions　Ultrasound guided liver biopsy can effectively diagnose autoimmune liver disease, non-alcoholic fatty liver disease, alcoholic liver disease, drug-induced liver injury, liver vascular disease, and neoplastic disease. Autoimmune liver disease and non-alcoholic fatty liver disease are mainly found in female patients, and alcoholic liver disease is mainly found in male patients, which is able to provide help for the diagnosis of non-viral liver diseases.

Key words:

Non-viral liver diseases, Ultrasound, Liver biopsy

摘要：

目的　研究非病毒性肝病超声引导下的肝穿刺活检特征。方法　回顾性分析黄石市中心医院2021年7月至2022年7月收治的83例非病毒性肝病患者的临床资料，其中男37例，女46例，年龄（57.79±9.08）岁，所有患者入院后（治疗前）接受血常规、心电图等检查，由护理人员指导患者作屏气、呼气训练，并在超声引导下行肝穿刺活检。观察超声引导下肝穿刺活检并发症发生情况，观察超声引导下肝穿刺活检结果，观察超声引导下肝穿刺活检与临床诊断的符合率。结果　83例非病毒性肝病患者均顺利完成肝穿刺活检，肝穿刺活检完成后生命体征基本正常，其中55.42%（46/83）穿刺部位存在轻微疼痛，在穿刺结束后4.82%（4/83）出现胸闷、3.61%（3/83）血压下降。83例非病毒性肝病患者经活检穿刺确诊93.98%（78/83），其中自身免疫性肝病51.81%（43/83）、非酒精性脂肪肝18.07%（15/83）、酒精性肝病14.46%（12/83）、药物性肝损伤4.82%（4/83）、肝脏血管病变3.61%（3/83）、肿瘤性疾病1.20%（1/83），另有6.02%（5/83）未能明确病因。超声引导下肝穿刺活检诊断上述6种疾病与临床诊断的符合率分别为93.48%（43/46）、100.00%（15/15）、92.31%（12/13）、100.00%（4/4）、100.00%（3/3）、50.00%（1/2），整体符合率为93.98%（78/83）。结论　超声引导下肝穿刺活检能够有效地对自身免疫性肝病、非酒精性脂肪肝、酒精性肝病、药物性肝损伤、肝脏血管病变、肿瘤性疾病进行诊断，且自身免疫性肝病、非酒精性脂肪肝多见于女性患者，酒精性肝病多见于男性，能够为非病毒性肝病的诊断提供帮助。

关键词:

非病毒性肝病, 超声, 肝穿刺活检