特殊情况下的一种皮肤活检方法

A Method of Skin Biopsy under Special Circumstances

摘要: 目的：探讨对于特殊情况下(如有药物过敏史，尤其或可能麻醉药过敏等)如何进行皮肤活检。方法：采用“活剪钳法”进行皮肤活检。结果：采用活检钳法取得了显著效果，明显不同于传统方法，不良反应少。它的优点或适应症有：1) 有药物过敏(尤其或可能麻醉药过敏)史的患者；2) 特殊部位：如：肛门口新生物，足趾间或手指间，糜烂处，等；3) 病重患者，高龄患者，行动不便患者(如：瘫痪在床，在轮椅上)；4) 不用局部麻醉及缝合。它的缺点有：1) “浅”：有时达不到皮下层，血管肌肉层更不可能；2) 皮肤太厚太硬处不宜用此法：如：足底，头皮。结论：活检钳法对特殊情况下皮肤活检具有重要意义，操作简单，无风险，值得进一步研究和推广。

Abstract: Objective: To explore how to carry out skin biopsy under special circumstances (such as drug allergy history, especially or possibly anesthetic allergy). Methods: Skin biopsies were performed by “biopsy forceps method”. Results: The method of biopsy forceps has achieved remarkable effect, which is different from the traditional method, with less adverse reactions. Its advantages or indications are: 1) patients with a history of drug allergy (especially or may be allergic to anesthetics); 2) special parts: such as new organisms in the anal area, between toes or fingers, erosions, etc.; 3) patients with serious disease, elderly patients, and patients with mobility difficulties (such as paralysis in bed, in wheelchair); 4) no local anesthesia and suture. Its disadvantages are: 1) “shallow”: sometimes it can’t reach the lower skin layer, and it’s impossible to reach the musculovascular layer; 2) it’s not suitable to use this method when the skin is too thick and hard: for example, the sole of the foot and the scalp. Conclusion: The biopsy forceps method is of great significance for skin biopsy under special circumstances. It is simple and risk-free and worth further study and promotion.