Voss D M, Lynn K L
Department of Nephrology, Christchurch Hospital.
N Z Med J. 1995 Jan 25;108(992):8-10.
To review and audit our experience in the use of the semiautomated spring-loaded Biopty gun with ultrasound guidance for renal biopsy, and the results with those obtained eleven years earlier using the Franklin-modified Vim Silverman needle.
We reviewed retrospectively the hospital notes of all patients who under went a percutaneous renal biopsy over a 2 year period at Christchurch Hospital.
There were 126 renal biopsies in 117 patients. Proteinuria (32%) remained the most common indication for renal biopsy. Renal transplant dysfunction (21%) was the next most common indication. IgA nephropathy was more frequently diagnosed than 11 years previously. Despite the use of a finer (18 gauge versus 14 gauge) needle, specimen adequacy was not jeopardised. Bleeding complications (7.9%) are still a significant occurrence with the Biopty gun. Complications in nine of the 10 cases developed within 8 hours of the biopsy.
Over 50% of the renal biopsies were performed for the investigation of proteinuria or renal transplant dysfunction. The semiautomated spring-loaded Biopty gun with ultrasound guidance is easily used by the one operator but, in our experience, was not associated with a lower complication rate than the 14 gauge Vim Silverman needle. We now perform the elective percutaneous renal biopsy as a day case.
回顾并审核我们在超声引导下使用半自动弹簧式活检枪进行肾活检的经验，并将结果与11年前使用富兰克林改良的维姆·西尔弗曼针所获得的结果进行对比。
我们回顾性分析了克赖斯特彻奇医院在两年内接受经皮肾活检的所有患者的病历。
117例患者共进行了126次肾活检。蛋白尿（32%）仍然是肾活检最常见的指征。肾移植功能障碍（21%）是第二常见的指征。与11年前相比，IgA肾病的诊断更为频繁。尽管使用了更细的针（18号而非14号），但标本的充足性并未受到影响。活检枪导致的出血并发症发生率仍为7.9%，仍较为显著。10例并发症中有9例在活检后8小时内出现。
超过50%的肾活检是为了调查蛋白尿或肾移植功能障碍。超声引导下的半自动弹簧式活检枪便于单人操作，但根据我们的经验，其并发症发生率并不低于14号维姆·西尔弗曼针。我们现在将择期经皮肾活检作为日间手术进行。
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