Kersnik Levart T, Kenig A, Buturović Ponikvar J, Ferluga D, Avgustin Cavić M, Kenda R B
Department of Paediatric Nephrology, University Medical Centre, Ljubljana, Slovenia.
Acta Paediatr. 2001 Dec;90(12):1394-7. doi: 10.1080/08035250152708789.
Real-time ultrasound-guided renal biopsy (RB) with a biopsy gun has become a standard procedure in the treatment of children. The purpose of the study was to establish the complication rate after real-time ultrasound-guided RB with a biopsy gun, the adequacy of renal tissue samples for pathohistological tests, the rate of concurrence between clinical and pathohistological diagnoses, and the benefits of the procedure. From January 1994 to October 1999, 88 renal biopsies were performed on 82 children, 81 of whom (35M, 46F, aged 3-20 y) were included in this retrospective study. The nephrotic syndrome (in infants, older children, those with evidence of nephritis or failing corticosteroid therapy) was the most frequent indication of RB. Other indications were non-nephrotic proteinuria, nephritic syndrome, glomerular haematuria, renal allograft dysfunction, unexplained acute or chronic renal failure, and kidney disease progression monitoring. No serious complications were noted. The adequacy rate of renal tissue samples ranged from 93.1 to 96.6%, depending on which definition of the adequacy of renal tissue samples was used. Clinical and pathohistological diagnoses matched in 81.4% of the cases. Data obtained by RB were very beneficial to patients in terms of establishing, confirming or altering the diagnosis and, consequently, the treatment.
The results confirm that real-time ultrasound-guided RB with a biopsy gun is a safe procedure and provides information that is very beneficial to patients.
使用活检枪进行实时超声引导下肾活检（RB）已成为儿童治疗中的标准程序。本研究的目的是确定使用活检枪进行实时超声引导下RB后的并发症发生率、肾组织样本用于病理组织学检查的充足率、临床诊断与病理组织学诊断的符合率以及该程序的益处。1994年1月至1999年10月，对82名儿童进行了88次肾活检，其中81名（35名男性，46名女性，年龄3至20岁）被纳入本回顾性研究。肾病综合征（婴儿、大龄儿童、有肾炎证据或皮质类固醇治疗失败的患者）是RB最常见的指征。其他指征包括非肾病性蛋白尿、肾炎综合征、肾小球性血尿、肾移植功能障碍、不明原因的急性或慢性肾衰竭以及肾脏疾病进展监测。未观察到严重并发症。根据对肾组织样本充足性的不同定义，肾组织样本的充足率在93.1%至96.6%之间。临床诊断与病理组织学诊断在81.4%的病例中相符。RB获得的数据在确立、确认或改变诊断以及因此在治疗方面对患者非常有益。
结果证实，使用活检枪进行实时超声引导下RB是一种安全的程序，并能提供对患者非常有益的信息。
