彩色多普勒超声引导下经皮肾活检术的临床应用

The clinical study of percutaneous renal biopsy by automatic gun under real time color doppler ultrasound guidance

目的探讨彩色多普勒超声引导下斜角进针经皮肾穿刺活检术的安全性和成功率及其影响因素。方法回顾分析了兰州军区兰州总医院226例经临床诊断的慢性肾脏病患者在彩色多普勒超声引导下用美国BARD MAGNUM自动活检枪斜角进针行经皮肾穿刺活检术,对影响穿刺成功率的有关因素进行分析,并与普通超声引导下经皮肾活检术对比。结果穿刺成功222例,成功率为98.4%,有4例未取得足够病理诊断的肾组织标本,活检标本长度为(10.5±4.5)mm,获取肾小球数目为(16.7±6.3)个。本研究中所有病例均未发现严重并发症。肉眼血尿发生率为0.4%(1/226),肾周血肿发生率0.9%(2/226)。在获取肾小球数目和穿刺成功率与文献报道一致,而术后并发症方面,明显低于文献报道。结论彩色多普勒超声引导下斜角进针经皮肾活检术成功率高,并发症少,值得进一步观察和推广。

Objective To investigate the safety and efficacy of color doppler ultrasound-guided renal biopsy using an automated biopsy gun, analysis the related risk factor. Methods The retrospective analysis method were used. Two hundred twenty-six patients with proveded chronic kidney diseases admited Lanzhou General Hospital were performed renal biopsy using an automated BARD biopsy gun made in America. The successful rate and complications were analyzed, and compared with common ultrasound guidance. Results Adequate renal tissue for histologic diagnosis was obtained by BARD MAGNUM biopsy gun was 98.4% of the patients, the average length of renal tissue sample was（10.5 ± 4.5） milimeter, the average number of glomeruli was（16.7 ± 6.3）, the rate of gross hematuria was 0.4%. The total of complication was 0.9%（2/226）. Conclusion Ultrasound guided percutanous renal biopsy with BARD MAGNUM automated biopsy gun is a kind of safe and accurate method of performing renal biopsy for kidney disease.