肾活检术后并发肾周血肿与病理类型关系的研究

The study of relationship between perirenal hematoma and pathological type after renal biopsy

目的回顾性分析近10年。肾活检术后并发肾周血肿患者的临床资料，并探讨其与病理类型的关系。方法选择行肾活检的患者2062例，按年龄分为青年组（18—39岁，1634例）、中年组（40～59岁，323例）、老年组（≥60岁，105例），统计三组患者术后并发肾周血肿的情况和肾脏病理类型。结果三组患者中，原发性肾小球疾病（PGD）分别为1370、255和69例，继发性肾小球疾病（SGD）分别为264、68和36例。所有患者肾穿刺术后共并发肾周血肿379例，三组发生率分别为15．8％（325／2062）、1．8％（37，2062）、0．8％（17/2062），差异有统计学意义（P〈0．05）。PGD术后肾周血肿发生率为19．0％（322／1694），高于SGD的15．5％（57，368），差异有统计学意义（P〈0．05）。发生肾周血肿的三种常见PGD分别为IsA肾病7．4％（126／1694）、局灶／节段性病变4．2％（71，1694）和膜性肾病2．4％（41／1694）；狼疮性肾炎的肾周血肿发生率高达9．0％（33／368）。结论单中心资料显示，肾活检术后易并发肾周血肿的常见病理类型是狼疮性肾炎、ISA肾病、局灶／节段性病变和膜性肾病。

Objective The clinical data of postoperative perirenal hematoma after renal biopsy in recent 10 years were retrospectively analyzed,and its relationship with pathological type was explored. Methods From April 2003 to April 2013, 2062 patients of renal biopsy were enrolled and divided into 3 groups： youth group （ 18 - 39 years, 1634 cases）, middle age group （40 - 59 years,323 cases） and aged group （ ≥ 60 years, 105 cases）. Relationship between renal hematoma and pathology was analyzed. Results There were 1370, 255, 69 cases of primary glomerular disease respectively in 3 groups, and 264, 68, 36 eases of secondary glomerular diseases. Three hundred and seventy-nine in all patients were complicated with perirenal hematoma, and the incidence rates were 15.8%（325/2062）, 1.8%（37/2062）, 0.8%（17/2062） respectively. Incidence rate of hematoma in primary glomerular disease was higher than that in secondary diseases [ 19.0% （322/1694） vs. 15.5% （57/368） ]. Three most common primary glomerular disease in which perirenal hematoma occured was IgA nephropathy 7.4% （126/1694）, focal/segmental lesions 4.2% （71/1694） and membranous nephropathy 2.4% （41/1694）; while the incidence rate of lupus nephritis hematoma was as high as 9.0% （33/368）. Conclusion Single-center data shows that the most common pathology types of perirenal hematoma are lupus nephritis, IgA nephropathy, focal/segmental lesions and membranous nephropathy.