B超引导下肾穿刺活检500例临床与病理分析

Clinical and pathological analysis of B ultrasound-guided renal biopsy 500 cases

目的探讨500例采用活检枪在B超引导下经皮肾穿刺的肾病患者进行临床经验分析,为B超引导下肾穿刺的临床应用提供依据。方法选取自1998年至2011年在弋矶山医院就诊的采用活检枪在B超引导下经皮肾穿刺的肾病患者500例为研究对象,分析研究B超引导下经皮肾穿刺取材质量、并发症及临床病理诊断情况。结果 500例患者共行肾活检术516次,一次穿刺成功率达96.8%,二次穿刺成功率为100%;组织标本质量均良好,能够进行病理检查及病理学诊断;500例患者经穿刺后,有23例患者发生肉眼血尿,78例发生镜下血尿,49例患者发生肾周血肿,在休息24h后均好转,且所有患者中未出现动静脉瘘、感染现象。结论 B超引导下经皮肾穿刺活检在临床应用中取得了较好的效果,该方法操作简便,准确性好,取材成功率高,减少并发症,对疾病诊断、治疗、预后具有重要意义,值得在临床上广泛应用。

Objective To analyze the clinical experience in 500 cases of biopsy gun under B ultrasound - guided percu- taneous nephrolithotomy in patients with kidney disease, and to provide the basis for the clinical application of B ultra- sound - guided renal biopsy. Methods From 1998 to 2011,500 cases of kidney patients in our hospital B ultrasound - guided percutaneous biopsy gun, analysis of the material quality of B ultrasound - guided percutaneous nephrolithotomy complications and clinical and pathological diagnosis. Results Totally 500 patients with renal biopsy was performed in 516 times, a puncture success rate of 96. 8% , the second puncture success rate was 100% ; The quality of tissue sam- ples was good for pathological examination and pathological diagnosis ; 500 patients by puncture after 23 cases of patients with gross hematuria, microscopic hematuria occurs in 78 cases, 49 cases of patients with perirenal hematoma, were im- proved after the rest 24h, and all patients does not appear arteriovenous fistula, infection phenomenon. Conclusions B ultrasound - guided percutaneous renal biopsy in the clinical application of good results, the method is simple, good ac- curacy, based on a high success rate and reduce complications of the disease, diagnosis, treatment, prognosis signifi- cance worthy of wide application in clinical practice.