儿童肾活检术后出血与胡桃夹现象的相关性及危险因素分析  

Correlation Between Postoperative Bleeding in Children with Renal Biopsy and Nutcracker Phenomenon and Bleeding Factors Analysis

作　　者：邵文洁 周陈 欧长笛 杨斌 Shao Wenjie;Zhou Chen;Ou Changdi;Yang Bin(Department of Ultrasound,General Hospital of Eastern Theater of PLA,Nanjing 210002,China)

机构地区：[1]中国人民解放军东部战区总医院超声诊断科,南京市210002

出　　处：《中国超声医学杂志》2022年第9期1017-1020,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨肾病患儿经皮超声引导肾活检(PURB)术后出血与胡桃夹现象(NCP)的相关性,探讨PURB术后重度出血危险因素。方法 回顾性收集129例行PURB术患儿的临床资料,根据术前左肾静脉超声结果分为NCP组和非NCP组,根据术后超声检查结果及临床分为无出血组、轻度出血组和重度出血组。应用单因素分析PURB术后出血与NCP的关系,应用单因素及多因素Logistic分析PURB术后重度出血的独立危险因素。结果 单因素分析发现NCP组与非NCP组在PURB术后出血、重度出血差异无统计学意义(P>0.05)。多因素Logistic回归分析发现血小板计数<265×10^(9)/L、患儿不能配合、肾脏下极皮质厚度>7 mm是PURB术后重度出血的独立危险因素(P<0.05)。结论 NCP与PURB术后出血无显著相关性。术前、术中对患儿行呼吸配合训练、术后密切监测血小板计数较低及肾脏下极皮质较厚的患儿可降低术后重度出血的发生。Objective To explore the correlation between bleeding after percutaneous ultrasound-guided renal biopsy(PURB) and nutcracker phenomenon(NCP) in children. To explore the risk factors of severe bleeding after PURB. Methods 129 children were divided into NCP group and non-NCP group according to preoperative left renal vein ultrasound results, and were divided into no bleeding group, mild bleeding group and severe bleeding group according to postoperative ultrasound results and clinic. Univariate analysis was used to analyze the relationship between bleeding after PURB and NCP, and univariate and multivariate Logistic regression analysis was used to analyze the independent risk factors of severe bleeding after PURB. Results Univariate analysis showed that there was no significant difference in bleeding and severe bleeding between NCP group and non-NCP group. Multivariate Logistics regression analysis showed that the platelet count less than 265×10^(9)/L, children’s inability to cooperate and renal cortex more than 7 mm were the risk factors of severe bleeding after PURB(P<0.05). Conclusions There was no significant correlation between NCP and postoperative bleeding of PURB. Respiratory cooperation training for children before operation, and intensive monitoring the children with low platelet count and thicken renal cortex after operation can reduce the occurrence of severe postoperative bleeding.

关 键 词：儿童 超声 胡桃夹现象 肾活检 出血 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.9[医药卫生—诊断学]