超声引导下经皮肾穿刺活检的临床应用技巧研究(附612例分析)

目的 探讨超声引导下经皮肾穿刺活检的临床技巧,提高肾穿刺活检成功率.方法 应用自动活检装置,在超声实时引导下对612例患者行肾穿刺活检,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 612例患者中608例(99.3％)取材满足病理诊断需要,其中408例(66.7％)一针成功,4例因肾小球数目＜5个,不能满足病理诊断要求；平均穿刺针数1.22针,左肾穿刺比例占82％；并发腰痛及腰部不适103例(16.8％)、一过性肉眼血尿15例(2.5％)、肾周血肿9例(1.5％).结论 选用切割式穿刺针,超声实时引导、准确定位对提高一针取材成功率、减少并发症起决定性作用.

Study on Clinical Skill of Ultrasound-guided Percutaneous Renal Biopsy (612 Cases Attached Report)

Objective To explore the clinical skill of ultrasound-guided percutaneous renal biopsy, improve the successful rate of percutaneous renal biopsy. Methods 612 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 The amount of renal tissues from 608 （99.3%） patients was enough to meet the need of pathological diagnosis, 408 cases （66.7%） were successful at the first time, 4 cases did not get complete pathological diagnosis because of the renal glomerulus were less than 5. The average frequency of puncture was 1.22 times; 82% punctures occured on left renal. The main complications were osphyalgia and lumbar discomfort in 103 cases （16.8%）, temporal naked eye hematuria in 15 cases （2.5%）, and perirenal hematoma in 9cases （1.5%）. Conclusion Selecting the Tru-Cut needle, accurate direction and a suitable puncture point under ultrasound-guided are important in decreasing the complications of renal biopsy and improving the successful rate of first puncture.