多普勒超声引导下肾穿刺活检在肾脏病变患者诊断中应用

Application of Doppler ultrasound-guided renal needle biopsy in the diagnosis of patients with renal lesions

目的:探讨多普勒超声引导下肾穿刺活检在肾脏病变患者诊断中的应用价值。方法:选取我院于2017年6月-2020年8月在超声引导下行肾穿刺活检的86例肾脏病变患者作为研究对象,均在超声引导下进行肾穿刺活检,统计所有患者的取材次数、取材长度、光镜下肾小球个数、取材成功率、病理诊断结果和术后并发症发生率。结果:经统计,86例肾脏病变患者平均穿刺(2.14±0.68)次,平均取材长度为(13.93±3.02)mm,平均取得肾小球(18.24±4.37)个,均取材成功,取材成功率100%;其中患者穿刺2次和取材长度13~15mm的占比最高,分别为55.81%和45.35%;病理诊断结果显示,患者主要为Ig A肾病、膜性肾病和系膜增生性肾小球肾炎,分别占比为31.40%、29.07%和20.93%;86例患者经肾穿刺活检后的并发症发生率为15.12%。体重>65Kg肾穿刺活检患者平均穿刺次数、平均取材长度和并发症发生率均高于≤65Kg患者(P<0.05)。结论:对肾脏病变患者实施多普勒超声引导下的肾穿刺活检,取样成功率高、并发症发生率低,能明确病理分型,具有较好的辅助诊断价值,但对体重较重者应注意谨慎操作。

Objective:To explore the value of Doppler ultrasound-guided renal needle biopsy in the diagnosis of patients with renal lesions.Methods:A total of 86 patients with renal lesions who underwent ultrasound-guided renal needle biopsy in the hospital from June 2017 to August 2020 were enrolled as the research subjects.All underwent ultrasound-guided renal needle biopsy.The times and length of drawing materials,number of glomeruli under light microscope,success rate of drawing materials,pathological diagnosis results and the incidence of postoperative complications were statistically analyzed.Results:According to statistics,times of average puncture,length of average drawing materials,number of average glomeruli and success rate of drawing materials were(2.14±0.68)times,(13.93±3.02)mm,(18.24±4.37)and 100%,respectively.The proportions of patients with twice punctures and drawing materials length of 13-15 mm were the highest(55.81%,45.35%).The pathological diagnosis results showed that the symptoms of patients were mainly on Ig A nephropathy,membranous nephropathy and mesangial proliferative glomerulonephritis(31.40%,29.07%,20.93%).After renal needle biopsy,the incidence of complications was 15.12%.The average times of puncture,average length of drawing materials and the incidence of complications in patients weighting over 65Kg were higher than those not over 65Kg(P<0.05).Conclusion:After the application of Doppler ultrasound-guided renal needle biopsy in patients with renal lesions,success rate of sampling is high and the incidence of complications is low.The pathological classification can be clearly defined.And it is of good auxiliary diagnosis value.However,people with heavier weight should be cautious.