自动负压式与切割式活检枪在老年患者肾穿刺活检中的应用比较

Comparison of the auto-negative pressure generation renal biopsy device with Bard biopsy device in renal biopsy in the elderly

目的比较自动负压式活检枪与自动切割式活检枪（Bard活检枪）在老年肾脏病患者中的应用效能及术后并发症的发生情况。方法对我科行肾穿刺活检282例（自动负压组159例，自动切割组123例）老年肾脏病患者的穿刺组织标本质量和术后并发症的发生情况进行回顾性分析。结果自动负压组与自动切割组比较，在穿刺成功率（96．9％比95．1％，P〉0．05）和术后并发症肾脏周围血肿（29．6％比30．1％，P〉0．05）、肉眼血尿（1．9％比1．6％，P〉0．05）发生率等方面，差异均无统计学意义；然而在穿刺组织肾小球数[（17．9±11．5）个比（12．6±9．9）个]、肾组织平均长度[（11．5±5．0）mm比（7．8±3．0）mm]、平均宽度[（1．0±0．2）mm比（0．8±0．4）mm]比较，差异均有统计学意义（均P〈0．05）。结论在老年肾脏病患者应用自动负压式肾活检枪与自动切割式活检枪的穿刺成功率与并发症发生率上无明显不同，但自动负压式活检枪的取材较多，更能满足病理诊断的需要。

Objective To compare the efficacy and complications between an auto negative pressure generation biopsy device and Bard biopsy device in renal biopsy in the elderly. Methods A total of 282 patients in our department received renal biopsies with auto-negative pressure generation biopsy device （n= 159） versus Bard device （n= 123）. The quality of tissue biopsy specimen and postoperative complications were analyzed retrospectively. Results There were no significant differences in the success rate, incidences of perirenal hematoma and gross hematuria between the two groups（96.9% vs. 95.1%, 29.6% vs. 30.1%, 1.9% vs. 1.6%,P〉0.05）. While the average number of glomeruli, the average length and width of kidney tissue specimen were much more, longer or wider by the auto-negative pressure generation renal biopsy device than by the Bard device [（17.± 11.5） vs. （12.6±9.9）, （11.5±5.0）mm vs.（7.8±3.0） mm, （1.0±0.2） mm vs.（0.8±0.4） mm,respectively, all P〈0.05]. Conclusions There are no significant differences in the success rate and postoperative complications between auto-negative pressure generation renal biopsy device and Bard device. The auto-negative pressure generation renal biopsy device has the advantage in obtaining more renal tissue, with the same effectiveness and safety as the Bard device.