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儿童肾活检:119例连续病例的适应证、技术及疗效

Renal biopsy in children: indications, technique and efficacy in 119 consecutive cases.

作者信息

Bohlin A B, Edström S, Almgren B, Jaremko G, Jorulf H

机构信息

Department of Paediatrics, Karolinska Institute, Huddinge Hospital, Sweden.

出版信息

Pediatr Nephrol. 1995 Apr;9(2):201-3. doi: 10.1007/BF00860748.

Abstract

Consecutive renal biopsies were performed on native kidneys in 109 children and adolescents, aged 0.1-19.8 (mean 9.9) years (119 biopsies). Bleeding diatheses were excluded or treated pre-operatively with intravenous desmopressin acetate. Biopsies were performed by a radiologist under ultrasound imaging, using an automated spring-loaded device allowing selection of the length of the needle movement and score size. Diagnostically adequate tissue was retrieved in 118 of 119 (99.2%) biopsy procedures; 24-h post-biopsy ultrasonography disclosed a small haematoma of the biopsied kidney in 26% of the cases. No correlation was seen between the occurrence of haematoma and (treated) prolonged bleeding time or a decrease in the haemoglobin level. No major complications occurred. Newly developed macroscopic haematuria was reported by 7% and micturition pain by 7% of patients. Painful body movements were reported by 37%. We conclude that the use of ultrasound imaging and an automated gunshot technique is a safe and efficient method for performing renal biopsies in paediatric patients.

摘要

对109名年龄在0.1至19.8岁(平均9.9岁)的儿童和青少年的天然肾脏进行了连续肾活检(共119次活检)。术前排除出血性疾病或用静脉注射醋酸去氨加压素进行治疗。活检由放射科医生在超声成像引导下进行,使用自动弹簧加载装置,可选择针移动的长度和取材大小。在119次活检操作中的118次(99.2%)获取了诊断足够的组织;活检后24小时超声检查显示26%的病例活检肾脏有小血肿。血肿的发生与(治疗后的)延长出血时间或血红蛋白水平降低之间无相关性。未发生重大并发症。7%的患者报告出现新的肉眼血尿,7%的患者报告有排尿疼痛。37%的患者报告有身体活动疼痛。我们得出结论,超声成像和自动枪击技术的使用是在儿科患者中进行肾活检的一种安全有效的方法。

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