超声引导下经皮肾脏实质穿刺活检术后血肿的相关影响因素分析  

Analysis of related factors of hematoma after ultrasound-guided percutaneous renal parenchymal biopsy

作　　者：李利霞 刘江云[1] 张建蕾[1] 汪军虎 刘新羽[1] Li Lixia;Liu Jiangyun;Zhang Jianlei;Wang Junhu;Liu Xinyu(Department of Ultrasound Diagnosis,Yan′an People′s Hospital,Yan′an 716000,China)

机构地区：[1]延安市人民医院超声诊断科,延安716000

出　　处：《国际泌尿系统杂志》2024年第5期923-927,共5页International Journal of Urology and Nephrology

基　　金：陕西省卫生健康委员会科研项目(2021C005)。

摘　　要：目的分析超声引导下经皮肾脏实质穿刺活检术后血肿的相关影响因素。方法回顾性分析2020年2月至2023年2月于本院行超声引导下经皮肾脏实质穿刺活检术的100例肾病患者的临床资料。依据术后血肿形成情况将患者分为形成组和未形成组,每组各50例。分析不同肾活检病理类型和临床诊断患者的术后血肿发生情况,采用单因素与多因素logistic回归分析术后血肿的相关影响因素。结果100例患者中,术后血肿50例。肾活检病理类型主要为IgA肾病,术后血肿17例(56.67%);其次为系膜增生性肾小球肾炎,术后血肿12例(60.00%);再次为IgM肾病,术后血肿6例(46.15%)。100例患者临床诊断主要为肾小球肾炎,术后血肿28例(70.00%);其次为肾病综合征,术后血肿13例(37.14%)。两组患者的体质量指数患者比例、高血压患者比例、术中配合患者比例、促凝药物患者比例、起病时间、肾脏距离皮下深度、穿刺长度、穿刺次数、凝血酶原时间、血小板、血红蛋白、血白蛋白、血肌酐、血尿酸比较,差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,高血压、起病时间、临床分期、肾脏距离皮下深度等均是术后血肿的影响因素(均P<0.05)。结论超声引导下经皮肾脏实质穿刺活检术后血肿的相关影响因素为临床采取针对性的干预与预防措施来降低术后血肿形成风险提供了有效依据。ObjectiveTo analyze the related factors of hematoma after ultrasound-guided percutaneous renal parenchymal biopsy.MethodsA total of 100 nephropathy patients undergoing ultrasound-guided percutaneous renal parenchymal biopsy in our hospital from February 2020 to February 2023 were retrospectively analyzed,and were divided into two groups according to the formation of postoperative hematoma,with 50 cases in each group.The incidence of postoperative hematoma in patients with different pathological types and clinical diagnoses of renal biopsy were analyzed.The correlation factors of postoperative hematoma were analyzed by univariate and multivariate logistic regression.ResultsAmong the 100 patients,50 cases of postoperative hematoma.The main pathological type of renal biopsy was IgA nephropathy,with hematoma in 17 cases(56.67%).Followed by mesangial proliferative glomerulonephritis,12 cases(60.00%)of postoperative hematoma;There were 6 cases(46.15%)of postoperative hematoma with IgM nephropathy.The main clinical diagnosis was glomerulonephritis,with postoperative hematoma in 28 cases(70.00%).Followed by nephrotic syndrome,13 cases(37.14%)of postoperative hematoma.There were statistically significant differences in the proportion of patients with body mass index,proportion of patients with hypertension,proportion of patients with intraoperative coordination,proportion of patients with procoagulant drugs,time of onset,depth of kidney from subcutaneous,length of puncture,number of puncture,prothrombin time,platelet,hemoglobin,blood albumin,blood creatinine and blood uric acid between the two groups(all P<0.05).Multivariate logistic regression analysis showed that hypertension,time of onset,clinical stage,subcutaneous depth of kidney,et al.,were all influencing factors of postoperative hematoma(all P<0.05).ConclusionsThe related factors of hematoma after ultrasound-guided percutaneous renal parenchymal biopsy provides an effective basis for clinical targeted intervention and preventive measures to reduce the risk of post

关 键 词：活组织检查 针吸 肾 超声检查 血肿 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692[医药卫生—诊断学]