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实时超声引导下小儿经皮肾活检:传统方法与斜切向进针法对比

Real time ultrasound guided pediatric percutaneous renal biopsy: the traditional method versus angled tangential approach.

作者信息

Caliskan K C, Ozcelik G, Cakmakci E, Ulusay S M, Celebi A S, Turk S, Ozagari A, Karpat Z

机构信息

Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.

出版信息

JBR-BTR. 2014 Jul-Aug;97(4):206-10. doi: 10.5334/jbr-btr.96.

Abstract

AIM

The aim of the present study was to compare the success and complication rates of pediatric renal biopsy procedures between the angled tangential approach and the traditional approach.

METHODS

From 2004 to 2009 we prospectively enrolled pediatric patients who had undergone real time ultrasound guided renal biopsy with angled tangential approach. For comparison, we retrospectively reviewed pediatric patients who had undergone traditional renal biopsy between 2002 and 2004. Adequacy of renal tissue histopathological samples and the complication rates were compared between groups.

RESULTS

One hundred twenty-eight patients underwent traditional renal biopsy (Group A) while 166 patients underwent biopsy performed with angled tangential approach (Group B).The rate of inadequate material was higher in Group A compared to Group B (6.3% vs. 0.6%, p = 0.006). In four cases (three in Group A and one in Group B) renal biopsies revealed normal renal tissue. While a major complication (hemoperitoneum requiring transfusion) occurred in one case in Group A, no major complications were seen in Group B.

CONCLUSION

Compared with the traditional technique, the angled tangential approach resulted in a higher adequate material rate and lower complication rate.These findings indicate that angled tangential approach could be considered for pediatric percutaneous renal biopsies.

摘要

目的

本研究旨在比较斜切向进针路径与传统路径在小儿肾活检操作中的成功率及并发症发生率。

方法

2004年至2009年,我们前瞻性纳入了采用斜切向进针路径在实时超声引导下进行肾活检的小儿患者。为作比较,我们回顾性分析了2002年至2004年间接受传统肾活检的小儿患者。比较两组肾组织病理样本的充足率及并发症发生率。

结果

128例患者接受了传统肾活检(A组),166例患者接受了斜切向进针路径的活检(B组)。A组取材不足的发生率高于B组(6.3%对0.6%,p = 0.006)。4例肾活检显示肾组织正常(A组3例,B组1例)。A组有1例发生严重并发症(需输血的腹腔积血),B组未见严重并发症。

结论

与传统技术相比,斜切向进针路径取材充足率更高,并发症发生率更低。这些结果表明小儿经皮肾活检可考虑采用斜切向进针路径。

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