肾病综合征患者超声引导肾穿刺活检术后血肿发生率及与术前BMI的相关性分析  

Incidence of Hematoma and Its Correlation with Preoperative BMI in Patients with Nephrotic Syndrome after Ultrasound-guided Percutaneous Renal Biopsy

作　　者：杨君华 乐大峰 李声凤 韩浩川 林建美 张瑶琳 YANG Jun-hua;LE Da-feng;LI Sheng-feng;HAN Hao-chuan;LIN Jian-mei;ZHANG Yao-lin(Department of Nephrology,Ziyang Hospital West China Hospital of Sichuan University Ziyang Central hospital,Ziyang,Sichuan,641300,China)

机构地区：[1]四川大学华西医院资阳医院/资阳市中心医院肾内科,四川资阳641300

出　　处：《现代生物医学进展》2024年第19期3736-3740,共5页Progress in Modern Biomedicine

基　　金：2022年四川省基层卫生事业发展研究中心项目(SWFZ22-C-100)。

摘　　要：目的:探讨肾病综合征(NS)患者超声引导肾穿刺活检术(PRB)后血肿发生率与术前体质量指数(BMI)的相关性。方法:选取2019年1月~2023年10月本院行PRB的90例NS患者,根据PRB术后血肿发生情况分为血肿组31例和无血肿组59例。比较血肿最大长径>3 cm和最大长径≤3 cm患者例数;比较不同术前BMI患者PRB术后血肿发生情况和血肿大小;Logistic回归分析影响PRB术后血肿发生的相关因素;Spearman相关性分析PRB术后血肿及其大小与术前BMI的关系。结果:血肿组和无血肿组术前BMI和肌酐、尿素氮、PLT水平、穿刺长度和肾实质厚度方面差异显著(P<0.05);Logistic回归分析,术前BMI≤23.49 kg/m2和穿刺长度≥2 cm为影响PRB术后血肿的独立危险因素(P<0.05);不同术前BMI患者PRB术后血肿发生情况比较,差异有统计学意义(P<0.05);术前BMI患者PRB术后血肿大小无关(P>0.05);Spearman相关性分析,PRB术后有无血肿与患者术前BMI大小呈显著正相关(P<0.05),而PRB术后血肿大小与NS患者术前BMI无相关性(P>0.05)。结论:NS患者PRB术后血肿与术前BMI密切相关,术前BMI越低,血肿发生风险越高。Objective:To explore the correlation between the incidence of hematoma and preoperative body mass index(BMI)in patients with nephrotic syndrome(NS)after ultrasound-guided percutaneous renal biopsy(PRB).Methods:A total of 90 patients with NS undergoing PRB in the hospital were enrolled between January 2019 and October 2023.According to the occurrence of hematoma after PRB,they were divided into hematoma group(31 cases)and non-hematoma group(59 cases).The number of patients with maximum hematoma diameter>3 cm and maximum diameter≤3 cm was compared.The occurrence and size of postoperative hematoma in patients with different preoperative BMI were compared.The influencing factors of hematoma after PRB were analyzed by Logistic regression analysis.The relationship between hematoma,hematoma size after PRB and preoperative BMI was analyzed by Spearman correlation analysis.Results:There were significant differences in preoperative BMI,creatinine,blood urea nitrogen,PLT,puncture length and renal parenchyma thickness between hematoma group and non-hematoma group(P<0.05).Logistic regression analysis showed that preoperative BMI≤23.49 kg/m2 and puncture length≥2 cm were independent risk factors of hematoma after PRB(P<0.05).There were significant differences in the occurrence of hematoma after PRB among patients with different preoperative BMI(P<0.05),but there was no significant difference in hematoma size(P>0.05).Spearman correlation analysis showed that the occurrence of hematoma after PRB was significantly positively correlated with preoperative BMI(P<0.05),while hematoma size was not correlated with preoperative BMI(P>0.05).Conclusion:The occurrence of hematoma is closely related to preoperative BMI in NS patients after PRB.The lower the preoperative BMI,the higher the hematoma risk.

关 键 词：超声引导 肾穿刺活检术 术后血肿 体质量指数 穿刺长度 相关性 

分 类 号：R692[医药卫生—泌尿科学]