G Jia, D W Ding, Y Q Fang, T Li, L N Cui, Y L Shang, Y Han
{"title":"[经皮肝活检患者出血并发症的危险因素]。","authors":"G Jia, D W Ding, Y Q Fang, T Li, L N Cui, Y L Shang, Y Han","doi":"10.3760/cma.j.cn112138-20241031-00720","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effect of thrombocytopenia and coagulation dysfunction on bleeding complications in patients undergoing percutaneous liver biopsy. <b>Methods:</b> The clinical, laboratory, and demographic data of patients undergoing percutaneous liver biopsy at the First Affiliated Hospital of Air Force Medical University from January 2005 to January 2024 were retrospectively analyzed. The incidence of bleeding was recorded. Univariate and multivariate logistic regression analyses were used to assess the effects of thrombocytopenia and coagulation dysfunction on the risk of postoperative bleeding. Furthermore, we assessed the bleeding risk in patients with autoimmune hepatitis. <b>Results:</b> A total of 2 885 liver perforations were performed in 2 364 patients, 98.4% of whom had an autoimmune liver disease. There were 27 cases of postoperative bleeding (0.9%). The univariate logistic regression analysis showed that platelet count (PLT)(<i>P</i><0.05, <i>OR</i>=0.975), coagulation dysfunction (international normalized ratio; INR)(<i>P</i><0.05, <i>OR</i>=6.954), and cirrhosis (<i>P</i><0.05, <i>OR</i>=3.857) were associated with bleeding. The multivariate logistic regression analysis showed that PLT was an independent risk factor for bleeding (<i>P</i><0.05, <i>OR</i>=0.975). PLT scores of 40×10<sup>9</sup>/L and 65×10<sup>9</sup>/L can classify the bleeding risk of patients with thrombocytopenia into high, medium, and low risk. There was no difference in the risk of bleeding between the 40×10<sup>9</sup>/L<PLT≤50×10<sup>9</sup>/L and 50×10<sup>9</sup>/L<PLT≤99×10<sup>9</sup>/L groups (<i>P</i>>0.05, <i>χ</i><sup>2</sup>=0.10). The risk of bleeding in the 31×10<sup>9</sup>/L≤PLT≤40×10<sup>9</sup>/L group was higher than that in the 40×10<sup>9</sup>/L<PLT≤99×10<sup>9</sup>/L group (<i>P</i><0.05, <i>χ</i><sup>2</sup>=11.50) and was 0 in the 19×10<sup>9</sup>/L≤PLT≤30×10<sup>9</sup>/L group. The risk of bleeding in the 1.15<INR≤1.5 group was higher than that in the INR≤1.15 group, and the risk of bleeding was 0 when 1.5<INR≤2.5. Compared with other liver diseases, the risk of bleeding was not increased in patients with autoimmune hepatitis (<i>P</i>>0.05, <i>χ</i><sup>2</sup>=0.10). Furthermore, the bleeding cases were considered mild as the bleeding stopped after pressure hemostasis. <b>Conclusions:</b> PLT is an independent risk factor for bleeding after hepatocentesis. When the PLT is >40×10<sup>9</sup>/L, hepatocentesis can still be performed safely with appropriate management measures.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"542-548"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Risk factors for bleeding complications in patients undergoing percutaneous liver biopsy].\",\"authors\":\"G Jia, D W Ding, Y Q Fang, T Li, L N Cui, Y L Shang, Y Han\",\"doi\":\"10.3760/cma.j.cn112138-20241031-00720\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective:</b> To investigate the effect of thrombocytopenia and coagulation dysfunction on bleeding complications in patients undergoing percutaneous liver biopsy. <b>Methods:</b> The clinical, laboratory, and demographic data of patients undergoing percutaneous liver biopsy at the First Affiliated Hospital of Air Force Medical University from January 2005 to January 2024 were retrospectively analyzed. The incidence of bleeding was recorded. Univariate and multivariate logistic regression analyses were used to assess the effects of thrombocytopenia and coagulation dysfunction on the risk of postoperative bleeding. Furthermore, we assessed the bleeding risk in patients with autoimmune hepatitis. <b>Results:</b> A total of 2 885 liver perforations were performed in 2 364 patients, 98.4% of whom had an autoimmune liver disease. There were 27 cases of postoperative bleeding (0.9%). The univariate logistic regression analysis showed that platelet count (PLT)(<i>P</i><0.05, <i>OR</i>=0.975), coagulation dysfunction (international normalized ratio; INR)(<i>P</i><0.05, <i>OR</i>=6.954), and cirrhosis (<i>P</i><0.05, <i>OR</i>=3.857) were associated with bleeding. The multivariate logistic regression analysis showed that PLT was an independent risk factor for bleeding (<i>P</i><0.05, <i>OR</i>=0.975). PLT scores of 40×10<sup>9</sup>/L and 65×10<sup>9</sup>/L can classify the bleeding risk of patients with thrombocytopenia into high, medium, and low risk. There was no difference in the risk of bleeding between the 40×10<sup>9</sup>/L<PLT≤50×10<sup>9</sup>/L and 50×10<sup>9</sup>/L<PLT≤99×10<sup>9</sup>/L groups (<i>P</i>>0.05, <i>χ</i><sup>2</sup>=0.10). The risk of bleeding in the 31×10<sup>9</sup>/L≤PLT≤40×10<sup>9</sup>/L group was higher than that in the 40×10<sup>9</sup>/L<PLT≤99×10<sup>9</sup>/L group (<i>P</i><0.05, <i>χ</i><sup>2</sup>=11.50) and was 0 in the 19×10<sup>9</sup>/L≤PLT≤30×10<sup>9</sup>/L group. The risk of bleeding in the 1.15<INR≤1.5 group was higher than that in the INR≤1.15 group, and the risk of bleeding was 0 when 1.5<INR≤2.5. Compared with other liver diseases, the risk of bleeding was not increased in patients with autoimmune hepatitis (<i>P</i>>0.05, <i>χ</i><sup>2</sup>=0.10). Furthermore, the bleeding cases were considered mild as the bleeding stopped after pressure hemostasis. <b>Conclusions:</b> PLT is an independent risk factor for bleeding after hepatocentesis. When the PLT is >40×10<sup>9</sup>/L, hepatocentesis can still be performed safely with appropriate management measures.</p>\",\"PeriodicalId\":68309,\"journal\":{\"name\":\"中华内科杂志\",\"volume\":\"64 6\",\"pages\":\"542-548\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华内科杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/cma.j.cn112138-20241031-00720\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华内科杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/cma.j.cn112138-20241031-00720","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
[Risk factors for bleeding complications in patients undergoing percutaneous liver biopsy].
Objective: To investigate the effect of thrombocytopenia and coagulation dysfunction on bleeding complications in patients undergoing percutaneous liver biopsy. Methods: The clinical, laboratory, and demographic data of patients undergoing percutaneous liver biopsy at the First Affiliated Hospital of Air Force Medical University from January 2005 to January 2024 were retrospectively analyzed. The incidence of bleeding was recorded. Univariate and multivariate logistic regression analyses were used to assess the effects of thrombocytopenia and coagulation dysfunction on the risk of postoperative bleeding. Furthermore, we assessed the bleeding risk in patients with autoimmune hepatitis. Results: A total of 2 885 liver perforations were performed in 2 364 patients, 98.4% of whom had an autoimmune liver disease. There were 27 cases of postoperative bleeding (0.9%). The univariate logistic regression analysis showed that platelet count (PLT)(P<0.05, OR=0.975), coagulation dysfunction (international normalized ratio; INR)(P<0.05, OR=6.954), and cirrhosis (P<0.05, OR=3.857) were associated with bleeding. The multivariate logistic regression analysis showed that PLT was an independent risk factor for bleeding (P<0.05, OR=0.975). PLT scores of 40×109/L and 65×109/L can classify the bleeding risk of patients with thrombocytopenia into high, medium, and low risk. There was no difference in the risk of bleeding between the 40×109/L9/L and 50×109/L9/L groups (P>0.05, χ2=0.10). The risk of bleeding in the 31×109/L≤PLT≤40×109/L group was higher than that in the 40×109/L9/L group (P<0.05, χ2=11.50) and was 0 in the 19×109/L≤PLT≤30×109/L group. The risk of bleeding in the 1.15P>0.05, χ2=0.10). Furthermore, the bleeding cases were considered mild as the bleeding stopped after pressure hemostasis. Conclusions: PLT is an independent risk factor for bleeding after hepatocentesis. When the PLT is >40×109/L, hepatocentesis can still be performed safely with appropriate management measures.
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