超声引导下肾移植活检的并发症及临床管理
Complications and clinical management of ultrasound-guided renal allograft biopsies.
作者信息
Fang Jiali, Li Guanghui, Xu Lu, Zhang Lei, Yin Wei, Lai Xingqiang, Guo Yuhe, Chen Rongxin, Li Li, Xiong Yunyi, Liu Luhao, Zhang Tao, Wan Jiao, Zhang Peng, Xu Hailin, Wu Jialin, Pan Guanghui, Ma Junjie, Chen Zheng
机构信息
Organ Transplant Center, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China.
出版信息
Transl Androl Urol. 2019 Aug;8(4):292-296. doi: 10.21037/tau.2019.07.23.
BACKGROUND
In this paper, the regular flow of ultrasound-guided renal allograft biopsies was established by analyzing complications and clinical management principle of ultrasound-guided renal allograft biopsies, to increase the safety of ultrasound-guided renal allograft biopsies.
METHODS
The purpose of this study was to analyze the cases of ultrasound-guided renal allograft biopsies in our hospital from January 2006 to October 2018 because of abnormal renal function (including symptoms of albuminuria and elevated serum creatinine). The type of puncture needle used in renal allograft biopsies, the number of puncture needle and the relationship between puncture needle and complication were counted, and the treatment measures were analyzed.
RESULTS
From January 2006 to October 2018, a total of 487 patients underwent ultrasound-guided renal allograft biopsies in our hospital. Among them, the successful sampling rate was 98.8%, and the average number of glomeruli per specimen was 15.24±2.26. The complications of the patient after puncture included: perirenal hematomas, subcapsular hematomas, acute ureter obstruction caused by hematuria, gross hematuria, and microscopic hematuria. Among them, two patients were treated with open surgery to save the function of renal transplantation, and the primary treatment measures were to increase the absolute bed rest time. The symptoms of the patients were relieved after treatment.
CONCLUSIONS
The analysis showed that ultrasound-guided renal allograft biopsies are safe and feasible, and the analysis of the biopsies of patients can provide meaningful pathological information for the clinic.
背景
本文通过分析超声引导下肾移植活检的并发症及临床处理原则，建立超声引导下肾移植活检的常规流程，以提高超声引导下肾移植活检的安全性。
方法
本研究旨在分析我院2006年1月至2018年10月因肾功能异常（包括蛋白尿症状及血清肌酐升高）而行超声引导下肾移植活检的病例。统计肾移植活检所用穿刺针类型、穿刺针数及穿刺针与并发症的关系，并分析治疗措施。
结果
2006年1月至2018年10月，我院共有487例患者接受超声引导下肾移植活检。其中，成功采样率为98.8%，每份标本的肾小球平均数量为15.24±2.26。患者穿刺后的并发症包括：肾周血肿、包膜下血肿、血尿引起的急性输尿管梗阻、肉眼血尿及镜下血尿。其中2例患者接受开放手术以挽救肾移植功能，主要治疗措施为增加绝对卧床休息时间。治疗后患者症状缓解。
结论
分析表明，超声引导下肾移植活检安全可行，对患者活检的分析可为临床提供有意义的病理信息。
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