肾穿刺活检术后大出血原因及救治方案探讨

目的 探讨肾穿刺活检术后大出血的原因及最佳救治方案,为临床诊疗提供借鉴.方法 分析作者医院2000/2010年1700例次超声引导经皮肾穿刺活检术中,3例肾脏大出血患者的临床病例特点与高危因素,探讨最佳救治方案.结果 肾穿刺活检术后大出血发生率1.76‰.2例患者肾活检术前有长期高血压病史,术前行血液透析治疗,3例患者...

Risk Factors of Severe Hemorrhage Following Percutaneous Renal Biopsy and Exploration of Therapy Method

Objective To evaluate the risk factors of severe hemorrhage following renal biopsy and assess the most effective therapy method.Methods In 1700 cases,3 cases with severe renal bleedings after kidney biopsies performed under real-time ultrasonograph guidance were studied.The clinical material were reviewed,the risk factors were analysed,and different therapy methods and outcomes were compared.Results The incidence of severe renal bleeding following renal biopsy was 1.76‰.Case 1 and 2 had hypertension for a long time and controlled well before biopsies.They both accepted hemodialysis.After bleeding,case 1 was recovered under internal medicine treatment;case 2 underwent surgeries twice and nephrectomy finally,resulting in total loss of renal function;case 3 underwent successful embolization after digital subtraction angiography（DSA） and his renal function remained stable.Conclusion Hypertension history,high serum creatinine levels and nephritic sclerosis are risk factors for severe hemorrhage after rental biopsy.Superselective embolization plus rental artery DSA is the most effective treatment method.