超声引导下经皮肾穿刺活检术后出血相关因素分析

Analysis of related factors of bleeding after ultrasound-guided percutaneous renal biopsy

目的探讨超声引导下肾穿刺活检术后出血的原因,为临床减少穿刺后出血提供对策。方法选取2019年12月~2020年8月行超声引导下肾穿刺活检术的152例患者作为观察对象,分为出血组及未出血组,对两组患者性别、年龄、术前血清肌酐值、穿刺针数、术中是否配合等因素进行统计学分析,探讨影响肾脏穿刺活检术后出血的相关因素。结果152例患者均取得满意病理标本,穿刺成功率100%,术后经超声检查复查诊断肾穿刺后出血42例(27.6%),术后未出血110例(72.4%),单因素分析显示患者年龄(≥60岁和<60岁)、穿刺针数(>2针和≤2针)、术前血清肌酐值(≥100μmol/L和<100μmol/L)、患者术中是否配合在出血组和未出血组间的差异具有统计学意义(P<0.05),而患者性别,尿蛋白值则与术后是否出血差异无统计学意义(P>0.05)。结论年龄越大,穿刺针数越多,术前血清肌酐值越高以及术中患者不能配合都会导致超声引导下肾穿刺活检术后出血的机会增加。

Objective To explore the causes of bleeding after ultrasound-guided renal biopsy,and to provide countermeasures for clinical reduction of bleeding after renal puncture.Methods All 152 patients who underwent renal biopsy from December,2019 to August,2020 were divided into two groups bleeding group and non-bleeding group.The sex,age,preoperative serum creatinine value,number of punctures and intraoperative cooperation between the two groups were statistically analyzed to explore the related factors affecting bleeding after renal biopsy.Results All 152 patients achieved satisfactory pathology,the success rate of puncture was 100%,and 42 cases(28%)were diagnosed as hemorrhage after renal puncture by ultrasound.There were 110 patients(72%)without postoperative bleeding.Univariate analysis showed that there were significant differences in age(≥60 years old and<60 years old),number of punctures(>2 times and≤2 times),preoperative serum creatinine values(≥100μmol/L and<100μmol/L)and intraoperative cooperation between bleeding group and non-bleeding group(P<0.05).In contrast,there was no statistically significant relationship between patient gender,urine protein value and postoperative bleeding or not(P>0.05).Conclusion The older the age,the more the number of punctures,the higher the level of serum creatinine before operation and the inability of patients to cooperate during operation will increase the chance of haemorrhage after ultrasound-guided renal biopsy.