超声引导下经皮肾穿刺活检术后出现肾包膜下血肿的危险因素分析

Analysis of risk factors of subcapsular hematoma after percutaneous renal biopsy under ultrasound guidance

目的分析超声引导下经皮肾穿刺活检术后出现肾包膜下血肿的危险因素。方法收集2015年11月~2017年11月本院收治的行超声引导下经皮肾穿刺活检术后出现肾包膜下血肿的患者135例作为试验组,以及同期行超声引导下经皮肾穿刺活检术后未出现肾包膜下血肿的患者133例作为对照组,分析两组的临床资料,并对其术后出现肾包膜下血肿的危险因素进行深入的探讨。结果促凝药物的使用与否、穿刺次数、穿刺长度、血尿酸、凝血酶原时间、血肌酐、血白蛋白、血小板、血红蛋白、起病时间是超声引导下经皮肾穿刺活检术后肾包膜下血肿出现的相关危险因素,其中血肌酐是高危因素,P<0.05,具统计学差异。结论对于超声引导下经皮肾穿刺活检术的患者,围术期应加强对血肌酐的监测,同时临床医师应提高自身穿刺技术,最大限度的降低肾包膜下血肿发生率。

Objective To analyze the risk factors of subcapsular hematoma after percutancousrenal biopsy under ultrasound gnidance. Methods From November 2015 to November 2017, 135 patients with subcapsular hematoma after percutaneous nephrolithotomy under ultrasound-guided ultrasound were enrolled in the hospital as the experimental group and ultrasound-guided percutaneous nephrolithotomy. 133 patients with no subcapsular hematoma after biopsy were used as the control group. The clinical data of the two groups were analyzed and the risk factors of subcapsular hematoma were discussed. Results The use of procoagulant drugs, number of punctures, puncture length, blood uric acid, prothrombin time, serum creatinine, serum albumin, platelet, hemoglobin, and onset time were ultrasound-guided percutaneous nephrostomy after renal biopsy. The risk factors related to the occurrence of submural hematoma, among which serum creatinine is a high-risk factor, P 〈 0.05, with statistically significant differences. Conclusion For patients with ultrasound-gnided percutaneous nephrolithotomy, perioperative serum creatinine should be monitored, and clinicians should improve their own puncture techniques to minimize the incidence of subcapsular hematoma.