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彩色多普勒超声引导下经皮肾穿刺活检术后移植肾出血的压迫止血法

Color Doppler ultrasound-guided transducer compression of post biopsy bleeding of kidney transplants.

作者信息

Brabrand Knut, Midtvedt Karsten, Günther Anne, Marthinsen Pål Bache, Berstad Audun Elnaes

机构信息

Department of Radiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

出版信息

J Clin Ultrasound. 2013 Jan;41(1):26-31. doi: 10.1002/jcu.21983. Epub 2012 Aug 28.

Abstract

BACKGROUND

Color Doppler ultrasound (CDUS) has a potential of early detection of post biopsy bleeding. We describe CDUS guidance in planning, acquisition, and, in the case of bleeding, compression of the needle tract in biopsy procedures of kidney transplants.

METHODS

Eighty-three kidney transplant biopsy procedures performed on clinical indication were performed in 71 adult patients, 25 women, mean age 51 years, using CDUS and 18-G biopsy needles. Bleeding needle tracts were compressed using CDUS guidance.

RESULTS

CDUS immediately detected blood leakage and facilitated compression of the bleeding needle tract in 34 (41%) of the 83 procedures, including 53 (25%) of 215 needle passes. In 34 bleeding procedures, the mean duration of the longest bleeding time after a needle pass was 124 seconds (median, 20 seconds; range, 3-1440 seconds). In 12 of these procedures (35%), the bleeding time was 30 seconds or more. In six procedures (18%), a bleeding of 120 seconds or more was observed. Complications included seven small hematomas. Five hematomas developed in procedures where the longest duration CD bleeding was 120 seconds or more.

CONCLUSIONS

CDUS detects bleeding and facilitates direct transducer compression of the needle tract in a substantial portion of biopsy procedures of kidney transplants. Only minor hematomas occurred.

摘要

背景

彩色多普勒超声(CDUS)具有早期检测活检后出血的潜力。我们描述了在肾移植活检程序中,CDUS在穿刺计划、取材以及出血时对针道的压迫方面的指导作用。

方法

对71例成年患者(25例女性,平均年龄51岁)进行了83例基于临床指征的肾移植活检程序,使用CDUS和18G活检针。在CDUS引导下对出血的针道进行压迫。

结果

在83例程序中的34例(41%),包括215次进针中的53次(25%),CDUS立即检测到血液渗漏并有助于对出血针道进行压迫。在34例出血程序中,进针后最长出血时间的平均持续时间为124秒(中位数为20秒;范围为3 - 1440秒)。在其中12例程序(35%)中,出血时间为30秒或更长。在6例程序(18%)中,观察到出血时间为120秒或更长。并发症包括7个小血肿。5个血肿出现在最长CD出血持续时间为120秒或更长的程序中。

结论

在相当一部分肾移植活检程序中,CDUS可检测到出血并有助于直接用探头压迫针道。仅出现了小血肿。

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