Granata Antonio, Floccari Fulvio, Ferrantelli Angelo, Rotolo Ugo, Di Lullo Luca, Fiorini Fulvio, Logias Francesco, Gallieni Maurizio, Fiore Carmelo Erio
Departments of Nephrology and Dialysis and Internal Medicine, V. Emanuele Hospital, Via F. Paradiso 78/a, 95024 Acireale, Italy.
Int J Nephrol. 2011;2011:419093. doi: 10.4061/2011/419093. Epub 2011 Jul 25.
While ultrasonography is widely performed prior to biopsy, colour Doppler examination is often used only to discover post-biopsy complications. Aim of this paper was to evaluate the usefulness of colour Doppler examination in planning the optimal site of puncture for renal biopsy. Present analysis includes 561 consecutive percutaneous renal biopsies performed from the same operator. Until August 2000 332 biopsies were performed after a preliminary ultrasonography (Group A). From September 2000, 229 patients underwent even a preliminary colour Doppler study (Group B). Postbioptic bleeding were categorized as minor (gross hematuria or subcapsular perinephric hematoma < 4 cmq of greater diameter) or major (hematoma >4 cmq of greater diameter; requiring blood transfusion or invasive procedures; leading to acute renal failure, urine tract obstruction, septicaemia, or death). Major complications were seen in 2.1% in Group A while in Group B only one case was reported (0.43%). Minor clinically significant complications occur in 7.8% in Group A and in 3.4% of cases of Group B. Colour Doppler reduced drastically the incidence of complications observed before the introduction of routine colour Doppler examination prior to biopsy. In our opinion, these data support the use of preliminary colour Doppler study when a biopsy is planned.
虽然超声检查在活检前被广泛应用,但彩色多普勒检查通常仅用于发现活检后的并发症。本文的目的是评估彩色多普勒检查在规划肾活检最佳穿刺部位方面的实用性。目前的分析包括由同一位操作者连续进行的561例经皮肾活检。到2000年8月,在初步超声检查后进行了332例活检(A组)。从2000年9月起,229例患者甚至进行了初步的彩色多普勒研究(B组)。活检后出血分为轻度(肉眼血尿或直径大于4cmq的肾周包膜下血肿)或重度(直径大于4cmq的血肿;需要输血或侵入性操作;导致急性肾衰竭、尿路梗阻、败血症或死亡)。A组主要并发症发生率为2.1%,而B组仅报告1例(0.43%)。A组轻度具有临床意义的并发症发生率为7.8%,B组为3.4%。彩色多普勒大大降低了在活检前常规彩色多普勒检查引入之前观察到的并发症发生率。我们认为,这些数据支持在计划进行活检时使用初步彩色多普勒研究。