超声引导下经皮肾穿刺活检术后出现肾包膜下血肿的危险因素分析  

Study on the risk factors of perinephric hematoma caused by percutaneous renal biopsy which guided by ultrasonic

作　　者：郑红光[1] 王玉慧[2,3] 张德伟[1] 王沙西[1] 梅煜明[1] 

机构地区：[1]沈阳军区总医院肾脏病科,沈阳100840 [2]大连医科大学 [3]沈阳军区总医院

出　　处：《中国实用内科杂志》2010年第10期919-921,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的分析经皮肾穿刺活检术后出现肾包膜下血肿的危险因素。方法回顾性分析2007年2月至2009年8月在沈阳军区总医院肾脏病科住院并于超声引导下进行经皮肾穿刺活检的427例患者的临床资料。结果术后经超声或CT诊断肾包膜下血肿发生率为7.7%,肉眼血尿发生率1.8%。出血相关因素的多因素分析显示硬化比例、系膜细胞及系膜基质增生情况对肾包膜下血肿形成具有统计学意义。多因素非条件Logistic回归分析显示,血清肌酐与出血具有明显相关性(P=0.052,OR=3.128)。结论血清肌酐升高可能是肾包膜下血肿形成的高危因素。病理变化以硬化病变为主的患者血肿发生率较高;系膜细胞及系膜基质增生情况对肾包膜下血肿发生有一定影响。Objective Analysing the risk factors f perinephric hematoma after percutaneous renal biopsy which guided by ultrasonic. Methods Retrospecting analysis the risk factors which contributed to perinephric hematoma in the 427 patients of our department who accepted percutaneous renal biopsy by ultrasonic guiding from Feb,2007 to Aug,2009. Results The incidence of perinephric hematoma and gross hematuria was 7.7% and 1.8% individually, sclerosis ratio, mesangium proliferation were significantly contributed to the perinephric hematoma according to the mulitiple factor correlation analysis, mulitiple factor unconditional logistic regression analysis proved that the creatinine was closely related with perinephric hematoma（ P = 0. 052, OR = 3. 12 ）. Conclusion High creatinine level was a high risk of perinephric hematoma, there were high incidence of perinephric hematoma in patients with priority of sclerosis of pathological change, mesangial ceils and mesangial matrix proliferation were also significantly contributed to the perinephric hematoma.

关 键 词：肾活检 肾包膜下血肿 血清肌酐 

分 类 号：R5[医药卫生—内科学]