It has become common knowledge for patients with chronic liver disease to visit the hospital, have their blood drawn for diphosphorus and liver function, and have their liver ultrasound done to understand the activity and severity of the disease, but it is not common knowledge that liver tissue specimens are taken for pathological examination through liver puncture to determine the severity of liver disease, and the importance and necessity of liver biopsy is often overlooked. Currently, the main means of examination for patients with liver disease are blood biochemistry, imaging, and liver tissue biopsy. Liver biopsy is a test that can directly understand the pathological changes of the tissue and make a more accurate diagnosis, and is recognized as the “gold standard”, its diagnostic value is much higher than the diagnostic value of blood biochemistry and imaging, and is irreplaceable by other tests. 1, to understand the degree and activity of liver lesions: liver puncture biopsy is a direct understanding of the pathological changes in the tissue, and can make a more objective and accurate diagnosis of the test method. There are many patients with chronic hepatitis B who have been infected with the liver disease virus for a long time, but abnormal transaminases may be found in blood tests for only six months, and the level of liver disease virus content is not high. Such patients can be detected by liver puncture whether the chronic liver disease is in an active stage and the severity of their lesions can be inferred. 2.Discovery of early, quiescent or still compensated cirrhosis: Especially liver fibrosis, which is generally difficult to detect through blood tests and B-ultrasound examination in the early stage of the disease. However, through liver aspiration examination, it is possible to make an accurate diagnosis of liver fibrosis and early, quiescent or still compensated cirrhosis, and to identify the clinical type of cirrhosis, distinguishing whether it is alcoholic cirrhosis, or post-hepatitis cirrhosis, and whether it is accompanied by active hepatitis. For example, some patients diagnosed as chronic asymptomatic liver disease virus carriers can be found to be active cirrhosis or chronic active hepatitis by liver aspiration. 3, conducive to drug selection and drug efficacy judgment: Histopathological changes in liver biopsy before and after treatment are reliable indicators for judging the effectiveness of drug therapy, providing an objective evaluation basis for clinical drug therapy. Currently commonly used anti-liver disease virus drugs are interferon and lamivudine, the application of interferon or lamivudine for antiviral therapy, not only the course of treatment is long, and expensive. If liver puncture can be performed before treatment, selective and targeted application of antiviral drugs according to the degree of inflammatory activity of liver tissue will significantly improve the efficacy. 4, to provide the basis for the pathogenic diagnosis of each type of viral hepatitis: most hepatitis viruses are hepatophilic viruses, and they tend to parasitize mostly in liver tissues. Only when the serum hepatophilic viruses reach a certain amount can clinical laboratory tests detect them. Therefore, there are still some viral hepatitis where clinical tests show all negative serum hepatophilic viral markers, making it difficult to determine their etiology. However, hepatitis viruses parasitized in liver tissue can be detected by liver puncture with ultrasensitive immunohistochemistry and in situ molecular hybridization techniques. 5.As an indicator of chronic hepatitis and prognosis: Liver aspiration can detect the lesion of liver tissue and provide a guest basis for the judgment of disease change and prognosis. If severe hepatitis is dominated by hepatocellular edema, the condition is more, the prognosis is better and the rate of death is lower; if hepatocellular necrosis is dominated and the rate of residual normal liver cells is lower, the condition is severe, the prognosis is worse and the rate of death is higher. 6, identify the nature and cause of jaundice: some clinical jaundice is often difficult to determine the cause, through liver biopsy can determine whether the jaundice is impaired bilirubin metabolism, or hepatocellular jaundice, or due to biliary stasis, viral or drug-induced. The prognosis and treatment are completely different for different causes, and only with a clear diagnosis can the correct treatment plan be formulated. 7, conducive to the differential diagnosis of a variety of liver diseases: many chronic liver diseases that are difficult to diagnose clinically, such as various types of viral hepatitis, alcoholic hepatitis, hepatic tuberculosis, hepatic granuloma, schistosomiasis, liver tumors, fatty liver, liver abscess, primary biliary liver sclerosis and various metabolic liver diseases (hepatomegaly, hepatic glycogen accumulation disease, hepatic amyloidosis), etc., often require liver aspiration to understand the patient’s liver lesions, providing an important and possibly decisive basis for definitive diagnosis. 8.Diagnostic treatment can be performed: Under the guidance of B ultrasound or CT, purposeful liver puncture can be performed to puncture and drain pus from liver abscess, inject drugs, and anhydrous alcohol intratumoral injection to treat liver cancer, etc. At the same time of puncture and diagnosis, diagnostic treatment can also be carried out, so that both diagnosis and treatment can be carried out.
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