The value of liver puncture needle biopsy has the following eight points

1. Conducive to the differential diagnosis of multiple liver diseases

Many chronic liver diseases that are difficult to clinically diagnose, such as various types of viral hepatitis, alcoholic hepatitis, liver tuberculosis, liver granuloma, schistosomiasis, liver tumor, fatty liver, liver abscess, primary biliary cirrhosis and various Metabolic liver disease (hepatolenticular degeneration, hepatic glycogen accumulation disease, liver amyloidosis), etc., often require liver puncture to understand the patient's liver lesions, and provide an important and possibly decisive basis for a clear diagnosis.

2. Understand the extent and activity of liver disease

Liver biopsy is an examination method that can directly understand the pathological changes of liver tissue and can make a more objective and accurate diagnosis. There are many chronic hepatitis B patients who have been infected with the liver disease virus for a long time, but the blood test found that the transaminase is abnormal for only half a year, and the level of liver disease virus is not high. Such patients can find out whether the chronic liver disease is in the active phase through liver puncture, and can infer the severity of the disease.

3. Provide the basis for the pathogenic diagnosis of various types of viral hepatitis. Most hepatitis viruses are hepatotropic viruses, and they are often parasitic in liver tissues. Only when the serum liver disease virus reaches a certain level, can clinical laboratory tests be able to detect it. Therefore, there are still some viral hepatitis, clinical laboratory tests show that all serum liver disease virus markers are negative, and it is difficult to determine the pathogen. However, through liver puncture, ultra-sensitive immunohistochemistry and in situ molecular hybridization techniques, hepatitis viruses parasitizing liver tissues can be detected.

4. Finding early, static or compensatory cirrhosis of liver cirrhosis, especially liver fibrosis, is generally difficult to find through blood tests and B-ultrasound in the early stage of onset. However, the liver puncture examination can accurately diagnose liver fibrosis and early, static or compensatory cirrhosis, and can distinguish the clinical types of cirrhosis, distinguish between alcoholic cirrhosis and post-hepatitis cirrhosis, and Whether it is accompanied by active hepatitis. For example, some patients diagnosed as carriers of chronic asymptomatic liver disease virus can be found to be active cirrhosis or chronic active hepatitis through liver puncture examination.

5. It is conducive to the choice of drugs and the judgment of drug efficacy

The pathological changes of liver biopsy tissues before and after treatment are reliable indicators for judging the effect of drug treatment, and provide an objective evaluation basis for clinical drug treatment. At present, the commonly used anti-hepatic virus drugs include interferon and lamivudine. The application of interferon or lamivudine for antiviral treatment is not only long, but also expensive. If liver puncture can be performed before treatment, selective and targeted application of antiviral drugs according to the degree of liver tissue inflammation will significantly improve the efficacy.

6. Identify the nature and causes of jaundice

Clinically, it is often difficult to determine the cause of jaundice, and liver biopsy can be done. It can determine whether jaundice is bilirubin metabolism disorder, or hepatocellular jaundice, or cholestasis, viral or drug-induced. Different causes, prognosis and treatment are completely different. Only when the diagnosis is clear can the correct diagnosis and treatment plan be formulated.

7. As an indicator of the condition and prognosis of chronic hepatitis

Liver puncture can find the pathological condition of liver tissue, and provide objective basis for the judgment of disease condition and prognosis. Severe hepatitis is mainly caused by hepatocellular edema, the condition is mild, the prognosis is better, and the mortality rate is lower; if the main hepatocyte necrosis, and the survival rate of normal hepatocytes is low, the condition is severe, the prognosis is poor, and the death rate is lower. The rate is high.

8. Diagnostic treatment is possible

Under the guidance of B-ultrasound or CT, purposeful liver puncture can carry out liver abscess puncture and pus drainage, injection of drugs, intratumoral injection of anhydrous alcohol to treat liver cancer, etc. While puncturing and obtaining materials and making diagnosis, diagnostic treatment can also be carried out to ensure that both diagnosis and treatment are not wrong.

The incidence of bleeding after liver puncture is about one in 100,000. Since liver biopsy technology is already mature, as long as the indications and contraindications are mastered, and adequate preparations are made before liver puncture, the operation of liver biopsy can be done. Foolproof.

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