Conlon P J, Kovalik E, Schwab S J
Division of Nephrology and Urologic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Clin Nephrol. 1995 May;43(5):309-11.
The etiology of acute renal failure in ventilated intensive care unit patients can be determined non-invasively in more than 80% of cases. When a pulmonary renal syndrome is suspected however it is important to obtain histological confirmation of the diagnosis prior to initiating therapy. Most text books and review articles have advocated the use of open surgical biopsy in this situation. Seven years ago we began to perform percutaneous renal biopsies on medical intensive care unit ventilated patients when a pulmonary renal syndrome was suspected as an alternative to an open surgical procedure. During this period we performed the technique on 7 patients. Adequate renal tissue was obtained in all cases. We compare the complication rate with that achieved using open surgical biopsy during the same time period. The complication rate using a percutaneous technique was similar to open renal biopsy. We believe that the previously held recommendation that percutaneous renal biopsy should not be performed on ventilated patients should be re-examined.
在通气的重症监护病房患者中，超过80%的急性肾衰竭病因可通过非侵入性方法确定。然而，当怀疑有肺肾综合征时，在开始治疗前获得诊断的组织学确认很重要。大多数教科书和综述文章都主张在这种情况下采用开放性外科活检。七年前，当怀疑有肺肾综合征时，我们开始对医学重症监护病房通气的患者进行经皮肾活检，作为开放性外科手术的替代方法。在此期间，我们对7例患者实施了该技术。所有病例均获得了足够的肾组织。我们将并发症发生率与同期采用开放性外科活检的发生率进行了比较。经皮技术的并发症发生率与开放性肾活检相似。我们认为，之前认为不应在通气患者身上进行经皮肾活检的建议应该重新审视。
