不同直径穿刺针在超声引导下肾穿刺活检中的应用研究

Study of Application of Different Needle Diameters in Ultrasound-guided Renal Biopsy

目的:研究不同直径穿刺针在超声引导下肾穿刺活检中的应用效果。方法:回顾性选取2018年10月-2020年10月本院收治的行超声引导下肾穿刺活检63例患者作为研究对象,按照使用的穿刺针直径不同将其分为16G组(n=29)与18G组(n=34)。记录病理诊断情况,并比较两组穿刺次数、肾小球数目、穿刺活检成功情况及术后并发症。结果:16G组穿刺次数比18G组少,肾小球数目比18G组多(P<0.05);16G组取材良好、合格、不足率分别为96.55%、3.45%、0,优于18G组的79.41%、17.65%、2.94%(P<0.05);16G组术后并发症发生率24.14%,与18G组的26.47%比较差异无统计学意义(P>0.05)。63例超声引导下肾穿刺活检患者经病理诊断发现,25例(39.68%)系膜增生性肾小球肾炎,10例(15.87%)IgA肾病,8例(12.70%)乙肝病毒相关性肾炎,6例(9.52%)膜增生性肾小球肾炎,6例(9.52%)轻微病变性肾病,5例(7.94%)膜性肾病,2例(3.17%)局灶性节段性肾小球硬化,1例(1.59%)患者因取材不足导致肾小球数量不足以进行病例确诊。结论:不同直径穿刺针在超声引导下肾穿刺活检中均有一定安全性,但16G穿刺针较18G穿刺针的取材质量更好,可明显减少穿刺次数。

Objective:To study the application effect of different needle diameters in ultrasound-guided renal biopsy.Method:From October 2018 to October 2020,a total of 63 patients who underwent ultrasound-guided renal biopsy in our hospital were retrospectively selected and divided into 16G group (n=29) and 18G group (n=34) according to the diameter of puncture needle.The pathological diagnosis condition was recorded,and the puncture times,the number of glomeruli,the success condition of puncture biopsy and postoperative complications were compared between the two groups.Result:The times of puncture in 16G group was less than that in 18G group,and the number of glomeruli was more than that in 18G group (P<0.05);the rates of good sampling,qualified sampling and insufficient sampling in 16G group were 96.55%,3.45% and 0 respectively,which were better than 79.41%,17.65% and 2.94% in 18G group (P<0.05);the incidence of postoperative complications in 16G group was 24.14%,and the difference was not statistically significant compared with the 26.47% in the 18G group (P>0.05).Sixty-three cases of ultrasound-guided renal biopsy were found by pathological diagnosis,including 25 cases (39.68%) of mesangial proliferative glomerulonephritis,10 cases (15.87%) of IgA nephropathy,8 cases (12.70%) of hepatitis B virus associated nephritis,6 cases (9.52%) of membranous proliferative glomerulonephritis,6 cases (9.52%) of mild degenerative nephropathy,5 cases (7.94%) of membranous nephropathy,2 cases (3.17%) of focal segmental glomerulonephritis,1 case (1.59%) had insufficient glomeruli for cases diagnosis due to insufficient sampling.Conclusion:Different puncture needle diameters have certain safety in ultrasound-guided renal biopsy,but the quality of 16G puncture needle is better than 18G puncture needle,which can significantly shorten the puncture times.