摘要
目的探讨超声引导下经皮肾组织穿刺活检术在肾脏疾病中应用效果。方法收集本院2015年5月～2018年8月间收治的46例肾内科住院患者,对临床资料回顾性分析,超声引导下行经皮肾组织穿刺活检术。观察取材成功率、术后并发症及病理结果。结果 46例患者中,取材成功率100%,其中42例(91.3%)1～2针取材成功,3例(6.5%)3～4针取材成功;术后,3例(6.5%)患者包膜下出现包膜下血肿,未经特殊护理,术后1周血肿吸收;2例(4.3%)出现肉眼血尿,2d内自行消失、1例(2.2%)患者因术前紧张,血压升高,服用降压药物血压控制、8例(17.4%)腰部疼痛明显,因长时间卧床所致,经按摩及定期翻身消失,未见其他严重并发症。病理结果显示,lgA肾病17例(36.9%)、系膜增生性肾小球肾炎14例(30.4%),所占比例最高,其次为微小病变性肾病4例(8.7%),局灶增生型紫癜性肾炎、高血压病肾损伤、糖尿病肾小球硬化症各2例(4.3%),坏死性肾小球肾炎、急性肾小管损伤、新月体性肾小球肾炎各1例(2.2%)。结论超声引导下经皮肾组织穿刺活检术取材成功率及穿刺命中率均较高,并发症少,可获得多种病理结果,值得采用。
Objective To explore the application effect of ultrasound-guided percutaneous renal biopsy in renal diseases. Methods 46 hospitalized patients who were admitted and treated in the department of nephrology in our hospital from May 2015 to August 2018 were selected and their clinical data were retrospectively analyzed. They were given ultrasound-guided percutaneous renal biopsy. The success rate of sampling, postoperative complications and pathological results were observed. Results In 46 patients, the success rate of sampling was 100%. Among them, 42 cases(91.3%) were successfully sampled with 1-2 stitches and 3 cases(6.5%) were successfully sampled with 3-4 stitches. After surgery, subcapsular hematoma was found in 3 patients(6.5%). Without special nursing, hematoma was absorbed in 1 week after surgery. Gross hematuria occurred in 2 cases(4.3%) and disappeared within 2 days. One patient(2.2%) took antihypertensive drugs to control blood pressure for elevated blood pressure due to preoperative progress. Eight patients(17.4%) had obvious lumbar pain, which was caused by prolonged bed rest. The lumbar pain disappeared after massage and regular turning over, and no other serious complications were found. Pathological results showed that there were17 cases(36.9%, the highest proportion) of lgA nephropathy, 14 cases(30.4%) of mesangial proliferative glomerulonephritis, 4 cases(8.7%) of minimally pathological nephropathy, 2 cases(4.3%) of focal proliferative purpuric nephritis, 2 cases(4.3%) of renal injury due to hypertension, 2 cases(4.3%) of diabetic glomerulosclerosis, 1 case(2.2%) of necrotizing glomerulonephritis, 1 case(2.2%) of acute tubular injury and 1 case(2.2%) of crescentic glomerulonephritis. Conclusion The success rates of sampling and puncture of ultrasoundguided percutaneous renal biopsy ware both relatively high. It has few complications and it can obtain a variety of pathological results, which is worthy of adoption.
作者
朱智勇
吕永聪
ZHU Zhiyong;LV Yongcong(Department of Ultrasound Diagnosis,Guangdong Hospital of Integrated Traditional Chinese and Western Medicine,Guangdong,Foshan 528200,China)
出处
《中国医药科学》
2019年第7期137-139,共3页
China Medicine And Pharmacy
