Meola M, Barsotti G, Cupisti A, Buoncristiani E, Giovannetti S
Istituto di Clinica Medica I, Chair of Nephrology, Università di Pisa, Italia.
Nephron. 1994;67(4):425-30. doi: 10.1159/000188016.
In the past 4 years we have carried out 650 percutaneous renal biopsies (PRB), 54 on transplanted and 596 on native kidneys. PRB was performed with a 14-gauge one-piece disposable needle that was introduced free-handedly into the lumbar wall without any form of fixed guidance or support. Ultrasound was used to locate the kidney pole and to follow the progression of the needle tip in the renal parenchyma. The time needed for the whole procedure was about 5 min. The tissue specimen was adequate for histological evaluation in 98.8% of the cases. The prevalence of post-biopsy complications (haematuria, pain, anaemia) was 2.5%. Haematuria was not a common complication (1.6%) in our series, whereas clinically silent perirenal haematoma was common. Mild perirenal bleeding (volume < 5 ml) was found in 40 of a series of 150 patients (26.6%) who underwent ultrasound scan 24 h after the PRB. Haematoma exceeding 100 ml was revealed with US in only 0.6% of the patients. We conclude that free-hand ultrasound-guided PRB makes this technique easier, highly successful, time-saving and almost free of severe side effects.
在过去4年里，我们进行了650例经皮肾活检（PRB），其中54例针对移植肾，596例针对自体肾。PRB使用的是14号一次性一体式穿刺针，徒手经腰壁刺入，无需任何形式的固定导向或支撑。利用超声定位肾极，并追踪针尖在肾实质内的进针过程。整个操作过程所需时间约为5分钟。98.8%的病例组织标本足以进行组织学评估。活检后并发症（血尿、疼痛、贫血）的发生率为2.5%。血尿在我们的系列病例中并非常见并发症（1.6%），而临床上无症状的肾周血肿较为常见。在150例患者中的40例（26.6%）于PRB术后24小时接受超声检查，发现有轻度肾周出血（出血量<5ml）。超声检查仅在0.6%的患者中发现血肿超过100ml。我们得出结论，徒手超声引导下的PRB使该技术更简便、成功率高、节省时间且几乎无严重副作用。
