152例老年肾脏病肾活检术的临床意义

Clinical evaluation of renal biopsy in 152 senile patients with kidney disease

目的探讨实时超声引导下自动活检枪经皮肾穿刺活检术在老年肾脏病中的临床意义及风险评估。方法回顾性分析152例老年肾脏病患者行肾自动活检术的成功率及并发症，并与同期2219例非老年组肾脏病患者进行比较。结果152例老年肾脏病患者肾活检均取得肾组织，其中取材不良6例（3．95％），取材合格27例（17．76％），取材良好119例（78．29％），与非老年患者比较，无统计学差异（P〉0．05）；152例老年患者中21例出现轻度并发症（13．82％），其中肉眼血尿7例，肾周血肿14例，无出现严重并发症，并发症发生率与非老年组无统计学差异（P〉0．05）；老年组通过。肾活检后修改诊断36例，诊断修正率为23．68％；根据病理结果修正治疗方案47例，治疗修正率为30．92％。结论超声引导自动肾活检术在老年肾脏病患者中应用成功率高且安全；肾活检病理诊断对老年肾脏疾病的诊治有重要价值，值得进一步推广应用。

Objective To evaluate clinical evaluation and side effect of automated renal biopsy guided by ultrasound in senile patients with renal diseases. Methods The data of 152 senile patients with renal diseases with automated renal biopsy gum were collected , the success rate , complications were studied retrospectively ,clinical value was analysed, and compared with that in 2219 non-elderly patients. Results The renal biopsies were technically successfully in 152 elderly patients. The qualities of the specimens were as follows： 6 cases （3.95%）failed for histological evaluation, 27 cases （17. 76%）although satisfied histological evaluation demand but not so good and 119 cases （78. 29%） very well qualified, showing no significant difference as compared with that in the non- elderly patients（P〉0. 05）. 21 cases（13.82%） had complications in senile patients, including gross hematuria in 7 cases, perirenal hematoma in 14 cases. No serious complication occurred. There was no significant difference of the frequency of complications in both groups（P〉0. 05）. According to the renal pathology acquired by biopsy, the diagnosis of the patients was reeorreeted in 23.68%, and treatment protoclols was adjusted in 30. 92% in elderly patients. Conclusions Ultrasound - guiede automated renal biopsy presented a very high success rate in senile patients with renal diseases and its replied renal biopsy was indispensable. Renal biopsy is of treat help to the diagnosis ,treatment for senti patients with renal diseases. It is worth extending.