浅析基层医院超声与CT引导下肾穿刺活检的应用

Analysis of the application of ultrasound and CT guided renal biopsy in primary hospitals

目的探讨超声与CT引导下肾穿刺活检在基层医院的应用效果。方法搜集河南省第二人民医院2017年—2021年33例超声及CT引导下肾穿刺患者作为研究对象,记录大体标本长度并进行光镜、免疫荧光检查和电镜检查,比较肾小球数目及穿刺术后并发症。结果超声引导下肾穿刺标本长度分为0.5~0.9 cm和1.0~2.0 cm两组,0.5~0.9 cm组时光镜肾小球为9.5(6~12.75)个,免疫荧光下肾小球为4(2~6)个;1.0~2.0 cm组时光镜下肾小球为9(8~10.5)个,免疫荧光下肾小球为4(3~6.5)个;CT引导下穿刺标本为1.0~2.0 cm时光镜肾小球为10(8~16.5)个,免疫荧光下肾小球为5(2.5~7.5)个;穿刺标本长度为1.0~2.0 cm时,超声引导下肾周出血发生率为11.11%,CT引导下肾周出血发生率为83.33%。结论超声及CT引导下肾穿刺活检可以明确肾脏疾病诊断,CT引导下肾穿刺获取肾小球个数较超声多,但肾周出血率较超声引导下高。

Objective To explore the effect of ultrasound and CT guided renal biopsy in primary hospitals.Methods Collected 33 patients with renal puncture under ultrasound and CT guidance in Henan Provincial the Second People’s Hospital from 2017 to 2021 as the study object,record the length of the general sample and con⁃duct light microscopy,immunofluorescence and electron microscopy,and compared the number of glomeruli and complications after puncture.Results The length of ultrasound-guided renal puncture specimens was divided in⁃to two groups:0.5-0.9 cm and 1.0-2.0 cm,with 9.5(6-12.75)glomeruli under microscope in 0.5-0.9 cm group and 4(2-6)glomeruli under immunofluorescence;In the 1.0-2.0 cm group,there were 9(8-10.5)glomeruli under microscope and 4(3-6.5)glomeruli under immunofluorescence;There were 10(8-16.5)glomeruli under microscope and 5(2.5-7.5)glomeruli under immunofluorescence when the puncture sample was 1.0-2.0 cm under CT guidance;When the length of puncture specimen was 1.0-2.0 cm,the inci⁃dence of ultrasound-guided perirenal hemorrhage was 11.11%,and that of CT-guided perirenal hemorrhage was 83.33%.Conclusion Ultrasound and CT-guided renal biopsy can determine the diagnosis of renal disease.The number of glomeruli obtained by CT-guided renal biopsy is more than that by ultrasound,but the rate of peri⁃renal hemorrhage is higher than that by ultrasound.