儿科经皮超声引导下肾活检的安全性概况。

Safety profile of paediatric percutaneous ultrasonography-guided renal biopsies.

机构信息

Department of Paediatrics, Charles University in Prague, Faculty of Medicine, University Hospital Hradec Králové, Hradec Králové, Czech Republic.

出版信息

Singapore Med J. 2010 Jun;51(6):481-3.

PMID:20658107

Abstract

INTRODUCTION

Renal biopsy (RB) is a decisive diagnostic procedure for patients with renal disease. Our aim was to assess the safety of RB and the prevalence of associated clinical complications.

METHODS

A total of 166 RBs were performed in 164 children (88 boys, 76 girls) in East Bohemia in 1997-2007. The mean age of the children was 12.9 +/- 4.1 years. All RBs were performed by a single consultant nephrologist. 27 biopsies were performed in 27 patients (16.3 percent) in 1997 under radiography control, while the remaining 139 biopsies (83.7 percent) were performed under ultrasonographic guidance. Renal ultrasonography (USG) following RB was not a general rule in patients who were biopsied under radiography control before 1998; therefore, only the USG results in patients after USG-guided RB (n = 139) were evaluated.

RESULTS

No major complications were encountered, and only minor complications occurred in 39 (23.5 percent) patients, which did not require medical intervention. The most common complication was asymptomatic perirenal haematoma, which was detected by USG one to three days after a USG-guided RB (30 out of 139 biopsies; 21.6 percent). Perirenal haematoma accompanied by abdominal pain occurred in two (1.4 percent) patients. Macroscopic haematuria was present in seven (4.2 percent) patients on Days 1-3 post biopsy. The complications were neither age-dependent nor were they related to the serum creatinine levels.

CONCLUSION

The results obtained are consistent with those in other reports of paediatric patients. The absence of major complications is a favourable outcome. Thus, the present practice of USG-guided percutaneous RB in children is safe and clinically beneficial.

摘要

简介

肾活检（RB）是诊断肾脏疾病患者的决定性程序。我们的目的是评估 RB 的安全性和相关临床并发症的发生率。

方法

1997 年至 2007 年，在东波希米亚对 164 名儿童（88 名男孩，76 名女孩）进行了总共 166 次 RB。儿童的平均年龄为 12.9 ± 4.1 岁。所有 RB 均由一位顾问肾病学家进行。1997 年，27 名患者（16.3%）在放射学控制下进行了 27 次活检，而其余 139 次活检（83.7%）在超声引导下进行。1998 年前接受放射学控制下活检的患者，RB 后通常不进行肾脏超声检查；因此，仅评估在超声引导下 RB 后（n=139）的患者的 USG 结果。

结果

未发生重大并发症，仅 39 名（23.5%）患者发生轻微并发症，无需医疗干预。最常见的并发症是无症状的肾周血肿，在超声引导下 RB 后 1-3 天通过 USG 检测到（30/139 次活检；21.6%）。有 2 名（1.4%）患者出现伴有腹痛的肾周血肿。7 名（4.2%）患者在活检后 1-3 天出现肉眼血尿。并发症既与年龄无关，也与血清肌酐水平无关。