Margaryan A, Perazella M A, Mahnensmith R L, Abu-Alfa A K
Section of Nephrology, Yale School of Medicine, New Haven, CT, USA.
Clin Nephrol. 2010 Dec;74(6):440-5. doi: 10.5414/cnp74440.
Native kidney biopsy is still performed primarily with hospital inpatient observation period. Experience with outpatient Computed Tomographic (CT)-guided renal biopsy at Yale New Haven Medical Center was studied to assess efficacy and safety. A total of 146 outpatient native kidney biopsies were identified between 1995 and 2001. Records were reviewed for demographics, clinical, and laboratory data and details of the procedure. Time of admission to the outpatient unit, duration of procedure and post-biopsy observation period were recorded. Complications such as bleeding, infection, admission to the hospital, transfusion, or intervention for continued bleeding were noted. Mean age was 43.9 ± 14.9 years and mean serum creatinine was 1.8 ± 1.4 mg/dl. Renal size averaged 11.4 cm. Post-procedure observation time of 4 - 6 h appeared to be adequate. Diagnostic tissue was successfully sampled in 98.6% of cases. Procedure was well tolerated with no hemodynamically significant changes. Hematocrit and hemoglobin concentration changes averaged 3.6 ± 2.5% and 1.0 ± 0.9 mg/dl, respectively (p < 0.001). There were no instances of death or need for intervention. Transfusion was required in 1 patient while 6 patients had detectable bleeding and were hospitalized for observation. Outpatient CT-guided kidney biopsy provides adequate tissue and appears to be safe with very low complication rates.
自体肾活检目前主要仍在医院住院观察期间进行。我们研究了耶鲁纽黑文医疗中心门诊计算机断层扫描（CT）引导下肾活检的经验，以评估其有效性和安全性。1995年至2001年间共确定了146例门诊自体肾活检病例。对人口统计学、临床和实验室数据以及手术细节的记录进行了回顾。记录了进入门诊科室的时间、手术持续时间和活检后的观察期。记录了出血、感染、住院、输血或因持续出血进行干预等并发症。平均年龄为43.9±14.9岁，平均血清肌酐为1.8±1.4mg/dl。肾脏平均大小为11.4cm。术后4 - 6小时的观察时间似乎足够。98.6%的病例成功获取了诊断性组织。手术耐受性良好，血流动力学无显著变化。血细胞比容和血红蛋白浓度变化平均分别为3.6±2.5%和1.0±0.9mg/dl（p<0.001）。没有死亡病例或需要干预的情况。1例患者需要输血，6例患者有可检测到的出血并住院观察。门诊CT引导下肾活检能提供足够的组织，且似乎很安全，并发症发生率极低。
