What is the clinical significance of liver needle biopsy?

1. It is beneficial to the differential diagnosis of various 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 diseases (hepatolenticular degeneration, hepatic glycogen storage disease, hepatic amyloidosis), etc., often require liver puncture to understand the patient's liver lesions, which provides important information for a clear diagnosis. , and may even be the decisive basis.

2. Understand the degree and activity of liver lesions: 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 liver disease virus for a long time, but it may not take a long time to find abnormal transaminase, and the virus content is not high. Such patients can find out whether the chronic liver disease is in the active stage through liver puncture, and can infer the severity of the disease.

3. Provide the etiological diagnosis of various types of viral hepatitis: there are still some viral hepatitis, and clinical tests show that all serum liver disease virus markers are negative, so it is difficult to determine the etiology. However, by liver puncture, using ultrasensitive immunohistochemistry and in situ molecular hybridization techniques, hepatitis virus in liver tissue can be detected.

4. Discovery of liver cirrhosis in the early stage, static or in the compensated stage: in the early stage of liver disease, it is generally difficult to find out whether the patient has liver cirrhosis through blood tests and B-ultrasound examinations. However, liver puncture examination can accurately diagnose liver fibrosis and liver cirrhosis in the early, static or compensated stage, and can identify the clinical types of liver cirrhosis, distinguish between alcoholic cirrhosis and post-hepatitis cirrhosis, and with active hepatitis.

5. It is beneficial to the selection of drugs and the judgment of the efficacy of drugs: the pathological changes of liver biopsy before and after treatment are reliable indicators for evaluating the efficacy of drug treatment, and provide an objective evaluation basis for clinical drug treatment. Currently commonly used antiviral drugs include interferon and nucleoside (acid) analogs. If liver puncture can be performed before treatment, and selective and targeted application of antiviral drugs according to the degree of inflammatory activity in liver tissue will significantly improve the curative effect

6. Identify the nature and cause of jaundice: It is often difficult to determine the cause of some jaundice clinically, and liver biopsy can be done. It can determine whether the jaundice is caused by bilirubin metabolism disorder, or hepatocellular jaundice, or caused by cholestasis, whether it is caused by a virus or a drug. Different etiologies, prognosis and treatment are completely different. Only with a clear diagnosis can a correct diagnosis and treatment plan be formulated.

7. As an evaluation index for the condition and prognosis of chronic hepatitis: Liver puncture can detect the lesions of liver tissue, and provide an objective basis for the judgment of disease changes and prognosis. If severe hepatitis is dominated by hepatocyte edema, the disease will be milder, the prognosis will be better, and the fatality rate will be low; if the liver cell necrosis is the predominant, and the residual rate of normal hepatocytes is low, the disease will be severe, the prognosis will be poor, and the fatality rate will be low. high rate.

8. Diagnostic treatment can be carried out: under the guidance of B-ultrasound or CT, purposeful liver puncture can be performed to perform liver abscess puncture to drain pus, injection of drugs, and intratumoral injection of anhydrous alcohol to treat liver cancer.

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