Zhang L, Li G L, Dang Z H, Wu L J, Liu L J
Department of Nephrology, People's Hospital of Tibet Autonomous Region, Lhasa 850000, China.
Renal Division, Institute of Nephrology, Peking University First Hospital, Beijing 100034, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2021 Mar 11;53(2):298-301. doi: 10.19723/j.issn.1671-167X.2021.02.011.
To observe the postoperative bleeding after percutaneous renal biopsy (PRB) in Tibet, To analyze and summarize the risk factors associated with bleeding in high altitude patients to improve the safety of surgery.
A retrospective analysis of 150 cases of PRB in the Department of Nephrology, People's Hospital of Tibet Autonomous Region from May 2016 to May 2018 were carried out, and the correlations between the potential risk factors (gender, age, blood pressure, hemoglobin, platelet, serum creatinine) and postoperative bleeding events were analyzed.
During the study period, the 150 patients receiving procedure of PRB were enrolled in our hospital, with an average age of (41.2±15.6) years, of whom 58.7% (88/150) were male, 41.3% (62/150) were female, and major bleeding complications occurred in 12 biopsies (8.0%, 12/150). Six cases for men and women, respectively. The mean age in the bleeding group seemed to be higher than that in the non-bleeding group [(48.3±20.0) years (40.6±15.1) years, =0.099]. There was no significant difference in the incidence of hypertension, hemoglobinemia, urea nitrogen and prothrombin time between the two groups. The level of serum creatinine in the hemorrhage group seemed to be higher than that in the non-bleeding group (=0.090), and the time of the hemorrhagic group was longer than that in the non-bleeding group (=0.069). The platelet count in the bleeding group was significantly lower than that in the non-bleeding group ( < 0.05). Multivariate Logistic regression analysis showed that the prolonged activation of partial prothrombin time and lower platelet count had a relatively high risk of bleeding, which was statistically significant (=0.079, =0.082).
PRB is safe and reliable on the whole in plateau areas; Old age, low platelet count, decreased renal function and prolonged activated partial coagulation time are related to postoperative bleeding of PRB, and hyperhemoglobin is not a risk factor for bleeding. High hemoglobin is not a risk factor for postoperative bleeding of PRB at high altitude.
观察西藏地区经皮肾穿刺活检术（PRB）术后出血情况，分析总结高原地区患者出血相关危险因素，以提高手术安全性。
回顾性分析2016年5月至2018年5月西藏自治区人民医院肾内科150例行PRB患者的临床资料，分析潜在危险因素（性别、年龄、血压、血红蛋白、血小板、血清肌酐）与术后出血事件的相关性。
研究期间，150例接受PRB手术的患者纳入我院，平均年龄（41.2±15.6）岁，其中男性58.7%（88/150），女性41.3%（62/150），12例活检发生大出血并发症（8.0%，12/150），男女各6例。出血组平均年龄似乎高于未出血组[（48.3±20.0）岁 （40.6±15.1）岁，=0.099]。两组高血压、血红蛋白血症、尿素氮及凝血酶原时间发生率无显著差异。出血组血清肌酐水平似乎高于未出血组（=0.090），出血组手术时间长于未出血组（=0.069）。出血组血小板计数显著低于未出血组（<0.05）。多因素Logistic回归分析显示，部分凝血活酶时间延长及血小板计数降低出血风险相对较高，差异有统计学意义（=0.079，=0.082）。
高原地区PRB总体安全可靠；高龄、血小板计数低、肾功能减退及活化部分凝血时间延长与PRB术后出血有关，高血红蛋白不是出血危险因素。高海拔地区PRB术后出血的危险因素不是高血红蛋白。
