Tru-cut型活检针在肾穿刺中的应用  

Application of Tru-cut Needle under B-ultrasound Guidance for Percataneous Renal Biopsy

作　　者：张丽琴[1] 陈连华[1] 陆建国[1] 季晓琪[1] 

机构地区：[1]南京医科大学附属淮安第一医院,江苏南京223300

出　　处：《黑龙江医学》2010年第12期922-924,共3页Heilongjiang Medical Journal

摘　　要：目的应用Tru-cut型活检针在B超引导下行经皮肾穿刺活检术。方法选择符合肾穿刺适应证342例,其中肾功能不全9例,使用Tru-cut型活检针在B超引导下行经皮肾穿刺活检术,与Menghini穿刺针负压抽吸式124例相比较。结果 （1）Tru-cut型活检针取出肾小球数多,〉10个小球达96.2%,成功率高;（2）出血为主要并发症,肉眼血尿发生率5.6%,肾周血肿2.6%,输血1 000 mL以上的严重出血并发症1例,占0.3%;（3）两种方法各有1例严重出血,均为CKD3期,血肌酐190~350μmol/L,尿蛋白3＋,双肾长径9.2~9.6 cm,皮质厚度正常回声增强,病理诊断：硬化性肾炎。但有5例双肾长径9.5~13.4 cm,血肌酐700~1 200μmol/L,病理示：硬化性肾炎、纤维性新月体肾炎、Goodpasture综合征、出血热肾损害和骨髓瘤肾病,使用Tru-cut型活检针者仅表现为镜下血尿。结论 Tru-cut型活检针相对负压抽吸法单人操作,简便易学,取材质量高,并发症相似。肾功能不全不是穿刺禁忌证,双肾偏小者需谨慎。Objective To use Tru-cut needle under B-ultrasound guidance for percataneous renal biopsy.Methods 342 patients were selected under meeting renal biopsy indication,9 of them with kidney insufficiency.Using Tru-cut needle under B-ultrasound guidance for percataneous renal biopsy.Compared with Menghini needle in negative pressure suction for 124 ones.Results（1）Tru-cut needle could obtain more glomerulus,96.2% could up to more than ten ones.Its achivement ratio was higher.（2）The main complication was hemorrhage.The incidence of macroscopic hematuria was 5.6%,perirenal hematoma was 2.6%.Only one of them（0.3%） had the severe hemorrhage complication that need blood transfusion for more than one thousand millilitre.（3）Each of the two methods had one severe hemorrhage,they were in CKD 3 phase,the serum creatinine was 190~350 μmol/L,urine protein 3＋,long diameter of kidney 9.2~9.6 cm,cortical thickness was normal but echo enhancement,its pathological diagnosis was sclerotic nephritis.Nevertheless,there were five ones Using Tru-cut needle,the complacation was only for microscopic hematuria.Whose kiney length 9.5~13.4 cm,serum creatinine 700~1 200 μmol/L,pathological diagnosis were sclerotic nephritis,fibrose crescentic nephritis,Goodpasture syndrome,hemorrhage fever kidney injury,myeloma nephropathy.Conclusion Compared to negative pressure suction,Tru-cut biopsy needle was single-opration,convenient,higher achivement ratio,and had similar complication.Kidney insufficiency wasn′t the contraindacation.But you should be careful for patients whose kidney was slightly small.

关 键 词：经皮肾穿刺活检 Tru-cut型活检针 负压抽吸式 B超引导 血尿 血肿 

分 类 号：R59[医药卫生—内科学]