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Application of percutaneous multi-angle oblique puncture renal biopsy under ultrasound guidance |
WU Yi-qiang1 CHEN Xie-hong2 WU Geng-mao1 |
1.Department of Nephrology,Jieyang People′s Hospital,Guangdong Province,Jieyang 515000,China;
2 Department of Ultrasound,Jieyang People′s Hospital,Guangdong Province,Jieyang 515000,China |
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Abstract Objective To explore the application safety and advantages of percutaneous multi-angle oblique puncture under ultrasound guidance in renal biopsy.Methods A total of 388 patients who underwent renal puncture in Jieyang People′s Hospital from June 2014 to December 2019 were selected as the research objects,and 72 patients who underwent renal puncture with a fixed-angle stent from June 2014 to April 2015 were selected as the control group (vertical puncture insertion),from May 2015 to December 2019,316 patients undergoing renal puncture with a variable-angle puncture stent were used as the experimental group.The experimental group was divided into group A (15°,132 cases),group B (25°,91 cases),group C (35°,56 cases),and group D (45°,37 cases) according to the puncture angle.The puncture success rate,specimen qualification rate,specimen length,glomerulus number,the incidence of postoperative urinary erythrocytosis,the incidence of perirenal hematoma,and the incidence of gross hematuria between the experimental group and the control group and among different groups in the experimental group were compared.Results The puncture success rate of the experimental group and the control group was 100.0%.The specimen qualification rate,specimen length and glomerulus number in the experimental group were higher than those in the control group,and the differences were statistically significant (P<0.05).There were no significant differences in the incidence rates of postoperative urinary erythrocytosis,gross hematuria,perirenal hematoma at 0 and 72 h after operation between the experimental group and the control group(P>0.05).There were no significant differences in the specimen qualification rate,specimen length,glomerulus number,the incidence rates of postoperative urinary erythrocytosis,gross hematuria,perirenal hematoma at 0 and 72 h after operation among different groups in the experimental group (P>0.05).Conclusion The application of multi-angle oblique puncture and individualized puncture angles can significantly increase the number of glomeruli obtained from puncture biopsy specimens without increasing the bleeding complications of puncture biopsy.
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[1] |
KDIGO.肾小球肾炎临床实践指南[M].王海燕译.北京:人民卫生出版社,2013:5.
|
[2] |
肾活检病理规范化诊断共识专家组.肾活检病理规范化诊断的专家共识[J].中华肾脏病杂志,2018,34(12):941-946.
|
[3] |
Nomoto Y,Endoh M,Suga T,et al.Minimum requirements for renal biopsy size for patients with IgA nephropathy[J].Nephron,1992,60(2):171-175.
|
[4] |
Korbet SM.Percutaneous renal biopsy[J].Semin Nephrol,2002,22(3):254-267.
|
[5] |
王海燕.肾脏病学[M].3版.北京:人民卫生出版社,2008:564.
|
[6] |
崔慧先,李瑞锡.局部解剖学[M].9版.北京:人民卫生出版社,2018:142.
|
[7] |
邹万忠.肾脏病理与临床[M].海口:海南科学技术出版社,1997:5.
|
[8] |
Al-Wakeel JS.Outcome of early ambulation after renal biopsy using automated biopsy needle by inexperienced trainees[J].Int Urol Nephrol,1998,30(4):399-405.
|
[9] |
冯茜,张兴玉.超声引导下经皮肾穿刺活检术后出血并发症及原因分析[J].影像研究与医学应用,2020,4(15):213-214.
|
[10] |
徐永通,张海静,冯涛,等.肾穿刺活检术后血肿感染危险因素分析[J].中华医院感染学杂志,2017,27(11):2498-2501.
|
[11] |
邹冬梅,黎渐英.预防性止血药对肾穿刺活检术后肾出血的影响[J].世界最新医学信息文摘(连续型电子期刊),2019,19(42):167.
|
[12] |
李航,陶建瓴,李超,等.肾活检后出血相关的危险因素分析[J].中华肾脏病杂志,2008,24(5):355.
|
[13] |
郑红光,王玉慧,张德伟,等.超声引导下经皮肾穿刺活检术后出现肾包膜下血肿的危险因素分析[J].中国实用内科杂志,2010,30(10):919-921.
|
[14] |
程瑞洪,简讯,李斌,等.经皮肾穿刺活检的超声引导技巧研究(附846例分析)[J].四川医学,2014,35(3):290-292.
|
[15] |
张海,张欣洲,何美霞,等.超声引导下肾活检穿刺角度选择的临床意义[J].中国超声诊断杂志,2003,4(6):449-450.
|
[16] |
杨文辉.超声引导角度对肾脏穿刺活检的影响意义[J].影像研究与医学应用,2018,2(1):115-116.
|
[17] |
孙德胜,鲁树坤,王丹军,等.彩色多普勒能量图引导肾活检的优缺点分析[J].中国超声诊断杂志,2005,6(11):840-842.
|
[18] |
蔡小丹,王庆文,俞雨生,等.一种更实用更安全的肾活检技术——斜角进针负压吸引法[J].肾脏病与肾脏移植杂志,1993,2(5):421-425.
|
[19] |
崔建国.基于解剖与影像特点的经皮肾镜穿刺研究[D].昆明:昆明医科大学,2016.
|
[20] |
盖维缤,韩振藩,吴新彦,等.肾盂肾盏的类型与肾段动脉的关系[J].解剖学通报,1966,(1):15-17.
|
[22] |
陈壮.肾动脉三维重建在mPCNL穿刺定位中的数字解剖研究[D].衡阳:南华大学,2010.
|
[21] |
de la Roset te J,Assimos D,Desai M,et al.The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study:indications,complications,and outcomes in 5803 patients[J].J Endourol,2011,25(1):11-17.
|
[23] |
雷伟.多层CT 在评价慢性肾病经皮肾穿刺活检术后并发症中的应用[D].杭州:浙江大学,2011.
|
[24] |
李继承,曾园山.组织学与胚胎学[M].9版.北京:人民卫生出版社2018:165.
|
[25] |
舒峤.彩超引导下斜角进针自动肾活检术的临床应用研究[J].中国医学工程,2012,20(7):36-37.
|
[26] |
覃夏川,王宝福,刘学彬,等.超声引导肾穿刺活检术后血肿形成的相关因素[J].西部医学,2020,32(4):572-575.
|
|
|
|