非穿刺探头超声导向经皮肾穿刺活检术的改良应用

The application and improvement in non-puncture probe ultrasound-guided percutaneous renal biopsy technique

目的改良应用非穿刺探头超声导向经皮肾穿刺活检技术,以期提高实用性和安全性。方法对58例患者进行充分的术前准备,并行非穿刺探头超声导向经皮肾穿刺活检技术,采用全自动活检枪、16G活检穿刺针和同轴引导针,病理组织行光镜、免疫荧光和电镜检查。结果 58例患者穿刺合格率为98.27%,病理诊断率为100.00%,病理诊断对临床诊断的修正率为20.61%,电镜诊断对光镜诊断的修正率为3.45%,病理诊断对治疗方案的修正率为15.52%。不良反应:镜下血尿或镜下血尿加重占53.45%,肉眼血尿占12.87%,肾周血肿占1.72%,肠胀气占5.17%,尿潴留占8.62%,发热占1.72%,经相应处理,均完全消失。结论改良应用非穿刺探头超声导向经皮肾穿刺活检术是一种安全、可靠的方法。

[Abstract] Objective To improve the application of non-puncture probe ultrasound-guided percutaneous renal biopsy technique, in order to improve the practicability and safety. Methods Non-puncture probe ultrasound-guided percuta- neous renal biopsy were performed in 58 patients with adequate preoperative preparation, using automatic biopsygun, 16G biopsy needle and a coaxial guide needle, and the pathological tissues were detected by light microscopy, im- munofluorescence and electron microscopic examination. Results On the basis of 58 patients, the puncture success rate was 98.27%, the pathological diagnosis accurate rate was 100.00%, and 20.61% of clinical diagnosis were cor- rected according to the pathological diagnosis, 3.45% of light microscopic diagnosis were corrected according to the electron microscopic diagnosis, and 15.52% of the therapy projects were adjusted according to the pathological resut. Adverse reactions： the incidence rate of complications of microscopic hematuria or microscopic hematuria aggravation was 53.45%, gross hematuria was 12.87%, perirenal hematoma was 1.72%, intestinal flatulence was 5.17%, urinary retention was 8.62%, and fever was 1.72%, after the corresponding treatment, all the complications were completely disappeared. Conclusion Improved application of a non-puncture probe ultrasound-guided pereutaneous renal biopsy is a safe, reliable method.