经皮肾穿刺活检的超声引导技巧研究（附846例分析）

目的探讨经皮肾穿刺活检术的超声引导技巧，提高肾穿刺活检成功率，降低并发症。方法回顾分析我院846例应用自动活检枪在超声实时引导下行肾穿活检患者的临床资料，对肾穿刺针数、穿刺肾别、获取的肾小球数目及并发症的情况进行统计分析。结果846例患者1次2针穿刺成功825例（97．52％），1次3针穿刺成功21例（2．48％）；活检肾小球10～20多个；795例（93．97％）行右肾穿刺，其余行左肾穿刺；并发腰痛及腰部不适126例（14．58％），肾周血肿22例（2．60％），一过性肉眼血尿18例（2．12％），无穿刺所致的感染。结论选用自动活检枪切割式穿刺针，超声实时引导、准确定位对提高肾穿活检一次性成功率、降低并发症起决定性作用。

Study on Clinical Skill of Guidance of Utrasonography in Percutaneous Renal Biopsy.

Objective To explore the clinical skill of guidance of utrasonography in percutaneous renal biopsy, improve the successful rate of percutaneous renal biopsy and reduce complications. Methods 846 patients with renal diseases underwent ultrasound-guided percutaneous renal biopsy. The relations between complications rates with the frequency of puncture, biopsied renal status, the amount of renal glomerulus were analyzed. Results 825 samples were successfully performed by 2 needle once, and 21 samples were successfully performed by 3 needle once, the renal glomerulus were more than 10 - 20. 93.97% punctures occured on right renal. The main complications were osphyalgia and lumbar discomfort in 126 cases（ 14.58% ） , perirenal hemato- ma in 22 cases （2.60%）, and temporal naked eye hematuria in 18 cases （2.12%）. Conclusion Selecting the Tru-Cut needle, accurate direction and a suitable puncture point under ultrasound-guided are important in improving the successful rate of first puncture and decreasing the complications of renal biopsy.