超声引导自动肾活检临床应用的进一步研究

目的 :进一步客观评价超声引导自动肾活检在弥漫性肾脏病诊治中的临床价值。方法 :采用大样本多因素多层次流行病学研究。 511例患者采用自动肾活检 (18G) ,另将 3 6例手动肾活检 (14 G)患者作为对照。结果 :自动活检组取材成功率 (91.0 0 % )显著优于手动组 (66.67% ) (P<0 .0 1) ;自动活检组并发症的发生率(7.44% )显著低于手动组 (66.67% ) (P<0 .0 1) ;在诸多因素中 ,急性肾功不全、高血压 (舒张压≥ 95mm Hg)、肾病综合征是影响自动肾活检并发症的独立因素。结论 :超声引导自动活检技术配以较细的 18G活检针用于弥漫性肾脏病组织学活检性能优越 ,并发症发生率明显减低 ,可以用来替代传统采用的手动粗针 (14 G)活检。

Further Study on Clinical Application of Ultrasound Guided Automatic Biopsy Technique in Diffuse Renal Diseases

Objective:To further evaluate clinica l a pplication of ultrasound guided automatic biopsy technique in diffuse renal dise ases.Methods:Epidemiological study of large samples with multi ple factors and multiple levels was adopted.Results:Sampling success rate obtained with automatic rena l biopsy technique was much higher than that of manual biopsy groups (91 00% an d 66 67%, P <0 01) Sampling success rate with automatic renal biopsy was n ot related to the length of tissue-core and the number of biopsy passes( P <0 05).The complications of automatic renal biopsy group were significantly lower than that of manual biopsy group(7 44% and 66 67% respectively, P <0 01) We found that the independent factors in many clinical factors which had influence on complications of renal biopsy were shown as follows:acute renal fa ilure and hypertension(diastolic pressure >95 mmHg) and nephrotic syndrome.Conclusions:Ultrasound guided automatic biopsy technique w ith biopsy gun(18G) in diffuse renal diseases has more advantages and less compl ications,and can substitute for manual renal biopsy(14G).