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肾活检在慢性肾衰竭中的价值。

Value of renal biopsy in chronic renal failure.

作者信息

Sobh M, Moustafa F, Ghoniem M

机构信息

Urology and Nephrology Center, Mansoura University, Egypt.

出版信息

Int Urol Nephrol. 1988;20(1):77-83. doi: 10.1007/BF02583035.

Abstract

A total of 120 patients with chronic renal failure secondary to parenchymatous kidney disease were biopsied. Percutaneous approach was tried and open technique was employed when there was contraindication to or failure of the percutaneous technique. In 72 cases the histopathologic lesions were identified, in 30 cases it was not possible to identify them and in 18 cases there was no sufficient kidney tissue. The diagnosis was very critical in at least 10 cases: there were 3 cases of primary oxalosis, one case of haemolytic uraemic syndrome, one case of necrotizing glomerulonephritis, one case of Wagner's granulomatosis, 3 cases of focal segmental glomerulosclerosis and one case of Fabry's disease. All but one of these were not diagnosed clinically. There was no patient mortality, and morbidity was significantly higher after open approach. We concluded that kidney biopsy in patients with chronic renal failure is mandatory especially if they are going to be transplanted and it is relatively safe especially when the percutaneous technique is employed.

摘要

对120例因实质性肾病继发慢性肾衰竭的患者进行了肾活检。尝试采用经皮穿刺方法,当经皮穿刺技术存在禁忌证或失败时采用开放手术技术。72例患者的组织病理学病变得以明确,30例无法明确病变,18例没有足够的肾组织。至少10例的诊断非常关键:原发性草酸中毒3例、溶血性尿毒症综合征1例、坏死性肾小球肾炎1例、韦格纳肉芽肿病1例、局灶节段性肾小球硬化症3例、法布里病1例。除1例之外,所有这些病例临床均未诊断出来。没有患者死亡,开放手术术后的发病率显著更高。我们得出结论,慢性肾衰竭患者进行肾活检是必要的,特别是在他们准备接受移植时,而且肾活检相对安全,尤其是采用经皮穿刺技术时。

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