透视下经皮经肾输尿管内钳夹活检诊断输尿管梗阻  

Clinical application of fluoroscopy-guided percutaneous transrenal ureteral forceps biopsy in diagnosing ureteral obstruction

作　　者：许凯豪 焦德超[1] 韩新巍[1] 朱明[1] 张庆辉[1] 李宗明[1] 黄元豪 XU Kaihao;JIAO Dechao;HAN Xinwei;ZHU Ming;ZHANG Qinghui;LI Zongming;HUANG Yuanhao(Department of Interventional Radiology,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China)

机构地区：[1]郑州大学第一附属医院放射介入科,450052

出　　处：《介入放射学杂志》2022年第1期45-48,共4页Journal of Interventional Radiology

基　　金：河南省教育厅重点研发项目(20A320024)。

摘　　要：目的评估透视下经皮经肾输尿管内钳夹活检诊断输尿管梗阻病变的可行性和安全性。方法2011年7月至2019年7月,29例输尿管梗阻患者在透视引导下,采用经皮经肾途径开通闭塞段,并经导丝建立9 F鞘管通道,经鞘引入活检钳和活检毛刷对梗阻段病变取样活检,比较两种方法获得的病理结果。结果29例输尿管经皮经肾输尿管钳夹活检中均顺利取材,技术成功率100%,27例获得组织学诊断,病理阳性率93.1%;28例毛刷活检中19例获得细胞学诊断,病理阳性率67.9%。钳夹活检灵敏度较毛刷刷检阳性率高(χ2=6.73,P<0.05),未发生大出血、输尿管穿孔、破裂、感染等严重并发症。结论经皮经肾输尿管内钳夹活检,操作简单,创伤小,并发症少,敏感性高,值得临床推广。Objective To evaluate the feasibility and safety of fluoroscopy-guided percutaneous transrenal ureteral forceps biopsy in diagnosing ureteral obstructive lesions.Methods From July 2011 to July 2019,a total of 29 patients with ureteral obstruction received fluoroscopy-guided percutaneous transrenal recanalization of obstructed ureteral segment.By using guide-wire,a 9 F sheath channel was established.Via the 9F sheath channel the biopsy forceps and the biopsy brush was introduced to the obstructive segment of ureter to get sampling biopsy.The pathological results were compared between the forceps biopsy method and the brush biopsy method by using chi-square testing,a difference of P<0.05 was considered to be statistically significant.Results Successful percutaneous transrenal ureteral forceps sampling was accomplished in all 29 patients,the technical success rate was 100%.Among the 29 patients,histodiagnosis was obtained in 27 patients with a pathological positive rate of 93.1%.In 28 patients receiving biopsy brush method,histodiagnosis was obtained in 19 patients with a pathological positive rate of 67.9%.The diagnostic sensitivity of forceps biopsy method was significantly higher than that of brush biopsy method(χ2=6.73,P<0.05).No serious complications such as massive hemorrhage,ureteral perforation,ureteral rupture,or infection occurred.Conclusion In diagnosing ureteral obstructive lesions,percutaneous transrenal ureteral forceps biopsy has several advantages,such as simple manipulation,less trauma,less complications and higher diagnostic sensitivity.Therefore,this technique is worthy of promotion in clinical practice.(J Intervent Radiol,2022,31:45-48)

关 键 词：钳夹活检 输尿管梗阻 病理学 临床研究 

分 类 号：R693[医药卫生—泌尿科学]