超声引导移植肾穿刺活检的临床应用  

Clinical Application of Ultrasound-guided Transplanted Kidney Biopsy

作　　者：王曦曦[1] 张翠红[1] 李智贤[1] 何云[1] 叶桂宏[1] 石尖兵[1] 易玲[1] 

机构地区：[1]广西医科大学第一附属医院超声科,南宁市530021

出　　处：《中国超声医学杂志》2008年第6期539-542,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广西壮族自治区科学技术厅资助项目(桂科自No.0542075)

摘　　要：目的探讨超声引导移植肾穿刺活检对肾移植术后并发症诊断的临床应用价值及穿刺技术要点。方法对24例患者的移植肾组织活检方法、病理结果与临床资料进行分析研究。结果24例患者术后共行36次肾穿,取材失败1次,穿刺成功率为97.2%,取材质量良好率为83.3%。病理诊断急性排斥反应22次、急性肾小管坏死9次、慢性排斥反应2次、其它肾组织病变17次。临床诊断与病理诊断完全符合者6次,约占17%;部分符合者21次,约占60%;完全不符合者8次,约占23%。结论超声引导移植肾穿刺活检对临床正确诊断术后并发症及选择治疗方案有重要价值。灵活选择移植肾穿刺路径和注意穿刺时机可更有效地避免穿刺并发症。Objective To investigate the clinical value and technical main points of ultrasound-guided transplanted kidney biopsy benifical for diagnosing complications after kidney transplantation. Methods Renal allograft biopsies in 24 cases after kidney transplantation were analyzed retrospectively. Results Totally 36 times of biopsy procedure were conducted in all 24 cases. The successful rate was was 97.2%.One procedure failed. The quality of the specimens was good in 30 procedures （83.3%） . Acute rejection occurred in 22 times, acute tubular necrosis in 9, chronic rejection in 2, and other renal allograft changes in 17. Clinical and histological diagnosis were completely concordant in 6 procedures （17% ）, and partially concordant in 21 procedures （60%）, and completely different in 8 （23%）. Conclusions Ultrasound-guided transplanted kidney biopsy may provide important clinical significance for correct diagnosis of renal allograft postoperative complications and for selecting appropriate management. To flexibly choose the technical pathway and to choose carefully the technical opportunity may be more effective to avoid the complications of transplanted kidney biopsy.

关 键 词：肾移植 超声 活组织检查 

分 类 号：R445.1[医药卫生—影像医学与核医学]