对133例超声引导下儿童经皮穿刺肾活检成功率和并发症分析

Success Rate and Complications of Percutaneous Renal Biopsy Under Ultrasound Guidance in 133 Children

目的:研究并探讨超声引导下儿童经皮穿刺肾活检的成功率,并对其并发症发生情况进行分析,为提高成功率、减少并发症提供借鉴和帮助。方法:收集本院2008年1月-2016年12月接受超声引导下经皮穿刺肾活检检查的133例患儿的病例资料进行回顾性研究分析,按照经皮穿刺肾活检成功与否、是否出现并发症将其分别分为成功组和失败组、并发症组和无并发症组。对各组的临床资料进行比较,并对影响超声引导下经皮穿刺肾活检成功率、并发症的危险因素进行分析。结果:133例患儿在超声引导下经皮穿刺肾活检的成功率为98.50%(131/133),其并发症发生率为18.80%(25/133),包括肉眼血尿11例、穿刺部位疼痛9例、皮下血肿5例。经分析,穿刺部位是影响超声引导下经皮穿刺肾活检成功率的主要危险因素;经单因素,穿刺肾活检失败患儿于肾门附近穿刺的概率为100%,而穿刺肾活检成功患儿于肾门附近穿刺的概率仅为50.38%。多因素Logistics回归分析后发现,超声引导下经皮穿刺肾活检出现并发症的危险因素主要为穿刺深度、穿刺部位(P<0.05)。结论:在超声引导下对儿童实施经皮穿刺肾活检的成功率较高,并发症主要以肉眼血尿、疼痛、皮下血肿为主,为提高其成功率、安全性,需严格掌握进针角度、穿刺深度。

Objective： To study and evaluate the success rate and complications of ultrasound guided percutaneous renal biopsy in children, in order to improve success rate and reduce the incidence of complications. Method： A total of 133 pediatric children who underwent ultrasound guided percutaneous renal biopsy in our hospital from January 2008 to December 2016 were collected and retrospectively analyzed, they were divided into success group and failure group by whether percutaneous renal biopsy was a success and complication group and non complication group by whether complications arose.Clinical data of children were compared and analyzed, the influence factors of success rate of ultrasound guided percutaneous renal biopsy and risk factors of complications were analyzed.Result： Success rate of ultrasound guided percutaneous renal biopsy was 98.50% （ 131/133 ）, the incidence of complications was 18.80% （ 25/133 ）, including 11 cases of hematuria, 9 cases of pain at the puncture site, 5 cases of subcutaneous hematoma.By analysis, the puncture site was the main risk factor that affected success rate of ultrasound guided percutaneous renal biopsies, the probability of puncturing the renal hilum near was 100% in the failed renal biopsy, and the probability of puncturing the renal hilum near was 50.38% for the successful biopsy of the renal biopsy.Single factor and Logistics regression analysis found that puncture depth and the puncture site were the main risk factors which occured complications in ultrasound guided percutaneous renal biopsy （P〈0.05） .Conclusion： Under ultrasound guidance, percutaneous renal biopsy of children had higher success rate, and main complications are hematuria, pain and subcutaneous hematoma.In order to improve the success rate and safety, it is needed to strictly control the angle and puncture depth of the needle.