超声引导下经皮肾穿刺活检的临床意义

The clinical significance of renopuncture biopsy guided by ultrasound

目的探讨灰阶B超引导下对肾脏疾病患者进行经皮肾组织穿刺活检的临床价值。方法采用GE200Pro黑白超声仪、穿刺探头、自动活检枪及组织切割针对肾下极进行穿刺,穿刺组织分别送光镜、电镜及免疫学检查。结果36例患者利用组织切割针进行肾穿刺,取出组织44条,电镜共检出452个肾小球送病理学检查,检出弥漫系膜增生性肾小球肾炎17例,IgA肾病8例,糖尿病肾病伴乙型肝炎相关肾炎1例,狼疮性肾炎2例,糖尿病肾病3例,局灶系膜增生性肾小球肾炎2例,肾小球轻微病变3例。结论经皮肾穿刺活检,对了解肾脏疾病的病理类型,指导临床治疗及判断疾病预后具有十分重要的意义。该方法操作简便、成功率高、并发症少,值得推广。

Objective To study the clinical significance of pereutaneous renopuncture biopsy guided by two- dimensional ultrasound. Methods GE 200pro ultrasound system and automatic biopsy device were applied for pereutaneous puncture in inferior pole of kidneys. Tissue samples were harvested for pathologic and immunologic examination. Results Thirty- six patients were biopsied and altogether 44 tissue samples with 452 renal glomerulus were collected for pathologic examination. The results of pathology showed that 17 cases were with diffuse mesangial proliferative glomerulonephritis, 8 cases with lgA nephrosis, 1 case with diabetic nephropathy and serum hepatitis related nephritis, 2 cases with lupus nephritis, 3 cases with diabetic nephropathy, 2 cases with focal mesangial proliferative glomerulonephritis, and 3 cases with slight renal glomerulus abnormality. Conclusions Pereutaneous renopuncture biopsy guided by ultrasound was of great importance for comprehending the pathologic types, leading treatment and judging the prognosis of renal diseases. This method is worthy of being applied widely because of its easy operation, high achievement ratio and rare complication.