肾自动活检术在老年肾脏病中的应用价值与风险评估

Clinical evaluation of automatic renal biopsy to senile patients with kidney diseases

目的评估超声引导肾自动活检术在老年肾脏病患者中的临床应用价值。方法回顾性分析我院肾内科6年间对老年肾脏病患者进行肾自动活检术的成功率和并发症并探讨其临床价值。结果106例患者活检手术总成功率100%,其中取材不良2例(1.9%),取材合格12例(11.3%),取材良好92例(86.8%);共5例出现轻度并发症(4.7%),其中肉眼血尿2例(1.9%),肾周血肿3例(2.8%),无严重出血并发症;肾活检结果对诊断与治疗的影响:临床诊断修正率为35.8%,治疗方案修正率为41.5%。结论肾自动活检术在老年性肾脏疾病患者中应用的成功率高而并发症少且大多较轻,其病理结果对明确诊断和决定治疗方案具有重要意义,值得进一步推广应用。

Objective To evaluate clinical value and side effect of automated renal biopsy guided by ultrasound to senile patients with kidney diseases. Methods The data of senile patients with kidney diseases with automated renal biopsy in our department were collected in the recent six years, the success rate, complications were studied retrospectively,clinical value was analysed. Results 106 cases of senile patients were performed by automated renal biopsy,all were carried out successfully. The qualities of the specimens were as follows; 2 cases （1.9%） failed for histological evaluation, 12 eases （11.3%） although satisfied histological evaluation demand but not so good and 92 （86.8%） eases very well qualified. Complications occurred in 5 eases （4.7%）. Among these complications,gross hematuria in 2 eases （1.9 %）, perirenal hematoma in 3 eases （2.8 %）. No severe hemorrhage occurred. According to the renal pathology acquired by biopsy,the diagnosis of the patients was recorrected in 35.8% and treatment protocols were adjusted in 41.5% accordingly. Conclusion Ultrasound-guided automated renal biopsy presented a very high success rate in senile patients with kidney diseases and its replied renal biopsy was indispensable and very usefull to correct diagnosis and to make properly therapeutic regimen. It is worth extending.