Restrick L J, Blomley M J, Drayson R A, Weston M J, Brown R, Hoffbrand B I
Whittington Hospital, London.
J R Coll Physicians Lond. 1993 Jul;27(3):247-51.
This paper reports a retrospective study of the clinical value of percutaneous renal biopsy in secondary referral centres. Between 1984-90, 205 patients over the age of 16 had 218 biopsies at three district general hospitals. Adequate tissue was obtained in 194 patients (95%, 89% of the biopsies). Significant complications occurred in only four patients. In 170 patients (83%) the biopsy yielded information of diagnostic and prognostic value and influenced management. The main indications for biopsy were nephrotic syndrome, in 63 patients, and chronic renal failure, in 58 patients. The most frequent findings were minimal change disease, focal segmental glomerulosclerosis, IgA nephropathy, membranous glomerulonephritis and mesangiocapillary glomerulonephritis. The most obvious association between indication and histology was between haematuria and IgA nephropathy. Percutaneous renal biopsy in the district general hospital in patients selected by a nephrologist and performed by experienced or supervised operators is a safe procedure. There is a high yield of renal tissue which is of clinical value in patient care.
本文报告了一项在二级转诊中心对经皮肾活检临床价值的回顾性研究。1984年至1990年间，16岁以上的205例患者在三家地区综合医院接受了218次活检。194例患者（95%，活检的89%）获得了足够的组织。仅4例患者发生了严重并发症。170例患者（83%）的活检产生了具有诊断和预后价值的信息并影响了治疗。活检的主要指征是肾病综合征（63例患者）和慢性肾衰竭（58例患者）。最常见的发现是微小病变性肾病、局灶节段性肾小球硬化、IgA肾病、膜性肾小球肾炎和系膜毛细血管性肾小球肾炎。指征与组织学之间最明显的关联是血尿与IgA肾病之间的关联。由肾病学家选择患者并由经验丰富或有监督的操作人员在地区综合医院进行的经皮肾活检是一种安全的操作。肾组织获取率高，对患者护理具有临床价值。
