119例超声引导下自动活检枪行肾活检分析

Kidney biopsy analysis of 119 cases performed with ultrasound-guided automatic biopsy gun

目的：探讨超声引导下使用自动活检枪行肾穿刺活检的临床应用价值。方法选取119例患者，其中男性61例、女性58例；年龄15~77岁，平均（41.38±14.62）岁。穿刺点选择在右肾下极肾皮质较厚部位，2%利多卡因局部麻醉后，在超声显示下沿引导线进针，取出组织条后快速放入10%甲醛溶液内固定和0.9%NaCl溶液内保存，分别送电子显微镜、光学显微镜及免疫荧光检查。结果119例患者共穿刺392针次，取出组织条长度3~20 mm，均符合病理学检查要求。术后发生镜下血尿46例，占38.7%；肉眼血尿11例，占9.2%；肾周血肿4例，占3.4%。119例患者术后均无严重并发症。结论彩超引导下自动活检枪行肾穿刺活检操作简洁、定位准确、成功率高、创伤小，还可避免严重并发症，对肾病的早期诊断与治疗具有重要意义。

Objective To investigate the value of kidney biopsy performed with ultrasound-guided automatic biopsy gun. Methods A total of 119 patients （61 males and 58 females） aged 15-77 years old were selected. The thicker cortex of lower pole of the right kidney was selected as puncture point. After local anesthesia with 2% lidocaine, the ultrasound-guided needle was inserted along the puncture line. The removed tissue stripes were placed in 10% formalin solution for quickly fixation and normal saline for preservation. And then the samples were sent for examination by electron microscopy, light microscopy and immunofluorescence. Results A total of 392 biopsies were performed in 119 cases. The length of removed tissue strips were 3-20 mm and met the requirements of pathological examination. The postoperative microscopic hematuria occurred in 46 cases （38.7%）, gross hematuria in 11 cases （9.2%）, and perirenal hematoma in 4 cases. There were no serious complications in all cases. Conclusion The kidney biopsy performed with ultrasound-guided automatic biopsy gun is simple with accurate positioning, high success rate and less invasion and complications. It is important in the early diagnosis and therapy of renal diseases.