超声引导下肾穿刺活检32例临床应用

Clinical application of renal puncture biopsy guided by ultrasound:A report of 32 cases

目的探讨超声引导下对肾脏疾病患者进行肾穿刺活组织检查的临床应用。方法采用PHILIPS超声仪、探头频率3.5MHZ的穿刺探头、自动活检枪及组织切割针对肾下极进行穿刺,穿刺组织分别送光镜、免疫荧光及电镜检查。结果32例患者31例一次取材成功,占96.8%,其中系膜增生性肾炎8人、IgAN 7人、微小病变6人、狼疮性肾炎4人、紫癜性肾炎2人、膜性肾病2人、乙肝相关性肾炎1人、肾淀粉样变1人、膜增生性肾小球肾炎1人。结论超声引导经皮肾穿刺活检,取材成功率高,并发症少,对了解肾脏疾病的病理类型、及时确定治疗方案及判断预后发挥重要作用。

Objective To investigate the clinical application of renal puncture biopsy guided by ultrasound.Methods PHILIPS ultrasound system,puncture probe with 3.5MHZ frequency,automatic biopsy device,and tissue incision needle were applied for renal puncture biopsy in inferior pole of kidneys.Tissue samples were gathered for pathologic and immunologic examination.Results A-mong the 32 cases,there were 31 cases that the tissue sample gathered by first time puncture was available （96.8%）.The pathologi-cal results indicated that 8 cases with mesangial proliferative nephritis ,7 cases with IgAN nephrosis ,6 cases with slight renal glomer-ulus abnormality ,4 cases were with lupus nephritis ,2 cases with purpuric nephritis ,2 cases with membranous ,1 case with hepatitis B virus-associated nephritis ,1 case with renal amyloidosis ,and 1 case with mesangial proliferative glomerulonephritis.Conclusion Percutaneous renal puncture biopsy guided by ultrasound is a reliable method with high availability rate of gathered tissue samples and rare complications.It plays important roles in pathologyical diagnosis ,treatment and prognosis.