64例急性肾功能衰竭肾穿刺活检的价值及并发症分析

Significance and complicaion of percutaneous renal biopsy in 64 patients with acute renal failure

目的:探讨急性肾功能衰竭(acute renal failure,ARF)患者经皮肾穿刺活检术(percutaneous renal biopsy,PRB)的临床应用价值及并发症。方法:对64例符合条件的ARF患者行PRB的临床资料进行回顾性分析。结果:PRB后病因诊断率由术前的75.32%提高至93.75%。PRB前后病因诊断符合率94.22%,病因诊断错误率4.69%。60例患者经PRB后确诊为ARF,4例临床误诊为ARF的患者经PRB后修正诊断为慢性肾功能不全(CRI)。术后有46.12%的患者治疗方案得到了补充,8.24%的患者更改了治疗方案,治疗方案修正率合计50.12%。并发症以镜下血尿最常见,发生率达97%。无误穿其他脏器、感染病例。结论:PRB对明确ARF病因诊断,及时明确治疗方案和判断预后有重要意义,其并发症较肾功能正常者无增加,较CRI发生率低。

Objective：To analyse the clinical significance and complications of percutaneous renal biopsy in 64 cases of acute renal failure（ARF）.Methods：64 patients with ARF received renal biopsy.The clinical data were analyzed retrospectively.Results：The final etiological diagnosis rate was elevated from 75.32% before PRB to 93.75 % after PRB.The coincidence of etiological diagnosis before and after PRB was 4.69%.Of 64 cases,60 were finally diagnosed as ARF,and the 4 remainders who were clinically misdiagnosed as ARF were finally diagnosed as chronic renal insufficiency（CRI）.The therapeutic regimen for 46.12% of patients was supplemented and for 8.24% of patients was modified after PRB.The total adjusted rate was up to 50.12%.Conclusion：PRB is a very useful technique for the etiological diagnosis of ARF on determining the therapeutic regimen and defining the prognosis.The complication does not increase,and the rate of complication is lower than that in the chronic renal failure.