Department of Nephrology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
Department of Radiology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
Clin Kidney J. 2015 Apr;8(2):151-6. doi: 10.1093/ckj/sfv012. Epub 2015 Mar 2.
Percutaneous renal biopsy (PRB) can result in serious complications. The study is aimed to compare the biopsy yield and complications rate of the real-time ultrasonagram (USG)-guided PRB and needle tracking with and without needle guide in two different study periods.
We compared the yield and complications of 2138 kidney biopsies performed in two different periods, 1510 biopsies during the first period from April 2004-December 2010 and 628 biopsies during second period from January 2011-March 2013. All biopsies in both periods were performed by nephrologists. Radiologists provided the real-time image without needle guide during the first period while nephrologists performed both imaging and biopsy with needle guide during the second period.
Of all the 2138 patients, 226 (10.5%) patients developed 118 minor and 108 major complications. Only 13 (2.1%) major complications occurred in the second period and 95 (6.7%) in the first period (P < 0.001). The relative risk of developing a major complication without guide was 3.04 times greater than that of the biopsies performed with use of the guide. The mean number of glomeruli per biopsy obtained during the second period (17.98 ± 6.75) was significantly greater than that of the first period (14.14 ± 6.01) (P = 0.004). The number of passes to acquire adequate tissue (P = 0.001) and percentage of cortex on biopsy (P = 0.001) were also significantly better in the second period. The optimal observation period post biopsy is 24 h.
Real-time USG imaging supported by needle guide device is associated with better biopsy yield and fewer complications.
经皮肾活检（PRB）可能导致严重并发症。本研究旨在比较实时超声引导下 PRB 与有和无针引导器的针道跟踪在两个不同研究时期的活检产量和并发症发生率。
我们比较了两个不同时期进行的 2138 例肾活检的产量和并发症，第 1 期（2004 年 4 月至 2010 年 12 月）进行了 1510 例活检，第 2 期（2011 年 1 月至 2013 年 3 月）进行了 628 例活检。两个时期的所有活检均由肾脏病学家进行。第 1 期放射科医生在无针引导器的情况下提供实时图像，而第 2 期则由肾脏病学家使用针引导器进行成像和活检。
在所有 2138 例患者中，226 例（10.5%）患者出现 118 例轻微并发症和 108 例严重并发症。仅在第 2 期发生 13 例（2.1%）严重并发症，第 1 期发生 95 例（6.7%）（P < 0.001）。无引导器发生严重并发症的相对风险是使用引导器时的 3.04 倍。第 2 期活检获得的平均肾小球数（17.98 ± 6.75）明显高于第 1 期（14.14 ± 6.01）（P = 0.004）。获取足够组织的穿刺次数（P = 0.001）和活检皮质百分比（P = 0.001）也明显更好。活检后最佳观察期为 24 小时。
实时超声引导并使用针引导装置与更好的活检产量和更少的并发症相关。
