超声引导下不同入路肾穿刺自动活检效果的比较  

Comparative Study of Efficacy on Percutaneous Renal Biopsy Guided by Ultrasound with Two Approaches

作　　者：廖锦堂[1] 黄铁汉[1] 肖萤[1] 黄渊金[1] 王书初[1] 潘瑞喆[1] 刘艳[1] 尹红玲[1] 

机构地区：[1]中南大学湘雅医院超声影像科,湖南长沙410008

出　　处：《中国医师杂志》2004年第12期1605-1607,共3页Journal of Chinese Physician

摘　　要：目的　研究超声引导下两种不同入路肾穿刺活检效果。方法　选取 15 0例因肾病住院的本院住院患者 ,随机分成 2组 :A组 74人 ,B组 76人 ,年龄基本匹配。A组患者穿刺时穿刺针自探头头端进针 ,B组自尾端进针。超声引导下使用自动活检枪 ,18G组织切割针行右肾下极穿刺活检 ,记录穿刺进针次数 ,测量每次进针所取标本长度 ,记录总长度 ,光镜下肾小球个数 ,计算单位长度内 (1cm)肾小球个数。结果　所有病例均获得了弥漫性肾病的分型诊断 ;两组穿刺进针次数A组 (2 4± 0 3次 )少于B组 (2 9± 0 2次 ) (P <0 0 5 ) ;肾小球总数 :两组差异无显著性 [A组 (10 0± 9 1)个 ,B组 (10 6± 9 3 )个 ,P >0 0 5 ) ] ;单位长度内肾小球个数 :A组 (7 0± 5 4)个大于B组 (4 8± 6 4)个 (P <0 0 5 ) ;穿刺并发症发生率两组无差别 ,均无严重并发症发生。结论　自头端进针途径较自尾端进针途径具有进针次数少 ,单位长度内肾小球个数多 ,操作方便等优点 ,超声引导下肾穿刺活检时 。Objective To investigate the efficacy of percutaneous automatic renal biopsy guided by ultrasound with two approaches. Methods One hundred and fifty patients who were suspected with diffuse renal disease were divided into two groups randomly: group A (n=74) and group B (n=76). In both groups A and B, an 18G cut needle with automatic biopsy gun was inserted the inferior pole of right kidney from proximal and distal end of transducer, respectively. After accomplishment, the times of puncture, length of sample, number of glomeruli and complications were recorded were recorded. And the number of glomeruli per centimeter was calculated. Results The differentiation of diffuse renal disease was assured by the specimens obtained by biopsy in all the patients. The puncture times in group A was less than those in group B (P<0.05). There was no significant difference in the total glomeruli between groups A and B (P>0.05), and the number of glomeruli per centimeter in group A was more than that in group B (P<0.05). There was no significant difference in the frequency of complications between groups A and B, and no serious complication occurred in all the patients. Conclusion The approach of proximal end of transducer was superior to that of distal end when a percutaneous renal biopsy guided by ultrasound was performed.

关 键 词：进针 肾小球 超声引导 入路 肾穿刺活检 自动活检 效果 个数 途径 结论 

分 类 号：R445.1[医药卫生—影像医学与核医学]