24例小儿经皮肾穿刺活组织病理检查临床分析  

The clinical applied analysis of percutaneous renal puncture for biopsy in children

作　　者：董扬[1] 叶学良[1] 陈雨青[1] 范靖[1] 

机构地区：[1]安徽省立儿童医院儿内科,安徽合肥230051

出　　处：《安徽医药》2004年第6期423-424,共2页Anhui Medical and Pharmaceutical Journal

摘　　要：目的　探讨小儿经皮肾穿刺活组织病理检查临床应用的价值和安全性。方法　对 1998年 8月～ 2 0 0 4年 7月收住的 ,有肾穿刺适应证 ,无禁忌证的 2 4例肾病患儿 ,在认真做好术前准备的情况下 ,由B超 (19例 )或CT(5例 )定位引导 ,局麻 (2 2例 )或全麻 (2例 )后 ,采用双人同步负压吸引 (8例 )或单人自动同步负压吸引 (16例 ) ,行小儿经皮肾活检。肾穿标本用冰盒直接送检 (8例 )或用特制邮寄盒远程送检 (16例 )。结果　 2 4例均获成功。穿刺获肾组织长度大于 1cm ,肾小球数大于 10个。其中系膜增生性肾小球肾炎 (MsPGN) 15例 ,局灶节段性硬化 (FSGS) 3例 ,膜增生性肾小球肾炎 (MPGN) 2例 ,IgA肾病 2例 ,膜性肾病 (MN) 2例。除一过性镜下血尿或个别肉眼血尿外 ,未发现其它并发症。 1周内可获得病理报告。结论　在小儿肾小球疾病中 ,肾活检是明确病理诊断、指导治疗、估计预后和科学研究等的重要手段。穿刺设备的不断更新 ,病理标本的远程邮寄 ,使这项检查更加安全、可靠、及时。Aim To study the clinical value and safe of renal puncture for biopsy in children with nephropathy. Methods Medical records and biopsy recorded from 1998.8～2004.7 were reviewed. 24 patients with nephropathy had undergone renal percutaneous renal biopsy. The biopsy was performed under real time ultrasound (n=19) or under CT (n=5) guidance utilizing Menghini style negative pressure biopsy device used by two people (n=8) or utilizing automatic synchronized negative pressure device used by one people (n=16) after local anesthesia (n=22) or general anesthesia (n=2) . The renopuncture tissues was directly sent by the ice-box in the same city (n=8) or was sent by the mail-boxes to the remote pathologic service (n=16).Results 24 cases are all successful. They have not any complication apart from transitory hematuria seen under microscope. The diagnosis were MsPGN (n=15), FSGS (n=3),MPGN(n=2), IgA nephropathy(n=2) and MN(n=2). Conclusion In clinical, the percutaneous renal biopsy become an accurate and safe procedure in diagnosing children with nephropathy by utilizing automatic synchronized negative pressure device.

关 键 词：儿童 肾活检 肾病 超声 CT 自动同步负压肾穿装置 远程邮寄病理检查 

分 类 号：R446.8[医药卫生—诊断学]