Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seoul 137-701, Republic of Korea.
BMC Nephrol. 2014 Jun 23;15:96. doi: 10.1186/1471-2369-15-96.
Although percutaneous renal biopsy remains an essential tool in the diagnosis and treatment of renal diseases, in recent times the traditional procedure of nephrologists has been performed by non-nephrologists rather than nephrologists at many institutions. The present study assessed the safety and adequacy of tissue yield during percutaneous renal biopsy according to practitioners and techniques based on ultrasound.
This study included 658 native renal biopsies performed from 2005 to 2010 at a single centre. The biopsies were performed by nephrologists or expert ultrasound radiologists using the ultrasound-marked blind or real-time ultrasound-guided techniques.
A total of 271 ultrasound-marked blind biopsies were performed by nephrologists, 170 real-time ultrasound-guided biopsies were performed by nephrologists, and 217 real-time ultrasound-guided biopsies were performed by radiologists during the study period. No differences in post-biopsy complications such as haematoma, need for transfusion and intervention, gross haematuria, pain, or infection were observed among groups. Glomerular numbers of renal specimens from biopsies performed by nephrologists without reference to any technique were higher than those obtained from real-time ultrasound-guided biopsies performed by expert ultrasound radiologists.
Percutaneous renal biopsy performed by nephrologists was not inferior to that performed by expert ultrasound radiologists as related to specimen yield and post-biopsy complications.
尽管经皮肾活检仍然是诊断和治疗肾脏疾病的重要工具,但在最近的许多机构中,传统的肾脏病医师操作过程已由非肾脏病医师而不是肾脏病医师进行。本研究根据医师和基于超声的技术评估了经皮肾活检期间的安全性和组织产量。
这项研究包括 2005 年至 2010 年在一个单一中心进行的 658 例原发性肾活检。活检由肾脏病医师或超声专家使用超声标记的盲法或实时超声引导技术进行。
在研究期间,共进行了 271 次由肾脏病医师进行的超声标记盲法活检,170 次由肾脏病医师进行的实时超声引导活检,以及 217 次由放射科医师进行的实时超声引导活检。各组之间的活检后并发症(如血肿、输血和干预、肉眼血尿、疼痛或感染)无差异。与由专家超声放射科医师进行的实时超声引导活检相比,未参考任何技术的肾脏病医师进行的肾活检的肾小球数量更高。
与专家超声放射科医师进行的实时超声引导活检相比,肾脏病医师进行的经皮肾活检在标本产量和活检后并发症方面并不逊色。