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作者为9例患者中的7例使用了Mansfield钳施行了经皮经股静脉肝活检。其中2例为不明原因肝硬变,4例行骨髓移植术,1例为慢性髓性白血病。Mansfield钳由不锈钢钳爪、不锈钢弹性环杆与控制钳爪张、合的柄构成。柄可驱动环杆变挺合和弯曲,便于跨越血管分叉达到钳取位置。钳长100cm,钳爪切割长度1.8至2.2mm,1.8mm钳曲度较大。采用标准Seldinger技术行右股静脉穿刺,将5 F端孔眼镜蛇导管置于右肝主静脉作静脉造影,必要时尚能测量肝静脉楔压和游离压。然后用0.035吋硬导丝置换5 F导管以便引入-8 F经隔套鞘,该鞘由一长的聚四氟乙烯平头导管与一扩张器构成,后者的曲度使之远端则易弯入肝右静脉。衬套内有垫圈及侧孔,以便灌注肝素盐水。钳子穿过套鞘,钳尖从导管终端露出进入静脉。当推进遇
The authors used Mansfield forceps for percutaneous transhepatic femoral liver biopsy for 7 of 9 patients. Two of them had unexplained liver cirrhosis, four had bone marrow transplantation, and one had chronic myeloid leukemia. Mansfield pliers are made of stainless steel jaws, stainless steel flexible rod and control jaws. The handle can drive the ring rod to become stiff and bend so as to reach the clamp position across the blood vessel bifurcation. Pliers length 100cm, jaw cutting length 1.8 to 2.2mm, 1.8mm greater curvature of the clamp. The standard Seldinger technique was used to perform the right femoral vein puncture. The 5 F ported cobra catheter was placed in the right hepatic vein for venography, and the hepatic vein wedge pressure and free pressure were measured as necessary. The 5F catheter was then replaced with a 0.035 "hard guidewire to introduce a -8F spacer sheath consisting of a long teflon catheter and a dilator, the curvature of which was distal Bend into the right hepatic vein. Gaskets and side bores are included in the liner for perfusion of heparin saline. Pliers through the sheath, the pliers tip exposed from the catheter into the vein. When pushed forward