引用文本：杨青, 徐明, 李红波, 等. 全自动活检针在超声引导下肝脏困难部位肿物穿刺活检中的应用研究[J/CD]. 消化肿瘤杂志（电子版）, 2025, 17(3):348-355.

作者：杨青1，徐明2，李红波1，姚佳倩2

单位：1. 郴州市第一人民医院超声医学中心，湖南 郴州 423000；2. 中山大学附属第一医院超声医学科，广东 广州 510080

Authors：Yang Qing1, Xu Ming2, Li Hongbo1, Yao Jiaqian2

Unit：1. Ultrasound Medical Center, the First People’s Hospital of Chenzhou City, ChenZhou 423000, Hunan, China；2. Department of Medical Ultrasonics, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China

摘要：

目的 探讨全自动活检针在超声引导下肝脏困难部位肿物穿刺活检中的应用价值及可行性。方法 回顾性分析2021年1月至2024年9月于郴州市第一人民医院行超声引导下肝肿物穿刺活检术的87例患者临床资料，其中男48例，女39例，年龄范围44~79岁。采用超声引导下全自动活检针对患者肝肿物行穿刺，取材1~4次。根据病灶的位置特征分为困难组（n=49）和非困难组（n=38），其中困难组再分为紧邻膈肌组（n=10），肝包膜下组（n=27），紧邻肝门组（n=12）三组亚组。比较困难组和非困难组、三组困难亚组之间的穿刺条数、穿刺活检成功率和并发症发生率。结果 共纳入87例患者的87个病灶，总体穿刺活检成功率为93.10%（81/87）。困难组和非困难组穿刺条数（P=0.274）、穿刺活检成功率（93.88%比92.11%，P=1.000）差异无统计学意义，并发症的发生率也相似（38.78%比52.63%，P=0.915）。三组困难亚组的穿刺活检成功率（紧邻膈肌组90.00% 比肝包膜下组92.59%比紧邻肝门组100.00%，P=0.771）及并发症发生率（30.00%比44.44%比33.33%，P=0.386）差异无统计学意义。结论 对于大小适宜的肝脏困难部位肿物，超声引导下使用全自动活检针穿刺取材，可在不增加穿刺条数的前提下，取得与常规部位相当的穿刺活检成功率，且不增加并发症发生风险。

关键词：肝脏肿物；困难部位病灶；穿刺活检；全自动活检针

Abstract：

Objective To evaluate the clinical application and feasibility of automatic biopsy needle in ultrasound-guided biopsy of liver masses in difficult sites. Method The clinical data of 87 patients who underwent ultrasound-guided liver mass biopsy in the First People’s Hospital of Chenzhou City from January 2021 to September 2024 were retrospectively analyzed. There were 48 males and 39 females, aging from 44 to 79 years old. Ultrasound-guided liver biopsies were performed for 1-4 times to procure adequate tissue specimens. The lesions were divided into complicated group (n=49) and non-complicated group (n=38) according to their location, and the complicated group was stratified into 3 subgroups: subcapsular masses (n=27), masses adjacent to diaphragm (n=10) and peri-hilar liver masses (n=12). Biopsy success rate and the incidence of complication were compared between complicated group and non-complicated group and three subgroups. Result This study included 87 patients with 87 liver masses. The overall biopsy success rate was 93.10% (81/87), with no statistically significant differences in number of biopsy cores (P=0.274), success rates (93.88% vs. 92.11%, P=1.000) or incidence of complication (38.78% vs. 52.63%, P=0.915) between complicated group and non-complicated group. Subgroup analysis within complicated cohort revealed no statistically significant differences in procedural success (masses adjacent to diaphragm 90.00% vs. subcapsular masses 92.59% vs. peri-hilar liver masses 100.00%, P=0.771) or complication profiles (30.00% vs. 44.44% vs. 33.33%, P=0.386). Conclusion For liver masses adjacent to vital sites, the use of automatic biopsy needle under ultrasound guidance can neither reduce the success rate of biopsy specimens nor increase the risk of complications without increasing the number of biopsy cores.

Key words：Liver mass; Lesions in difficult sites; Biopsy; Automatic biopsy needle

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