超声引导经皮穿刺肾脏组织活检术后的随访价值(1)
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【摘要】 目的 探讨超声引导下经皮穿刺肾脏组织活检术的临床应用及术后随访价值。 方法 对46例临床拟诊肾脏疾病的患者行超声引导经皮穿刺肾脏组织活检术，统计分析活检的成功率，术后24 h及48 h超声随访并发症的发生率及其导致原因。结果 46例(134针次)经皮穿刺肾组织活检的成功率为96%(129/134)；术后24 h超声随访并发症的发生率为26%(12/46),其中重度1例，轻度11例，肾周小血肿8例，肾周较大血肿3例，肾周大血肿伴腹腔出血1例；术后48 h超声随访并发症的发生率为30%(14/46)，与术后24 h比较，主要是肾周小血肿增加2例，共为10例；1例肾周大血肿伴腹腔出血者，腹腔出血量在增加。结论 超声引导下经皮肾脏组织活检术是比较安全、并发症较少的微创性检查技术,是目前临床肾脏疾病的诊断、指导治疗、判断预后不可缺少的低风险有效手段；作为一种有创介入手术，因为多种原因均可能导致并发症的发生，所以，常规进行术后超声随访是非常重要的，特别是术后24 h的超声随访，能够及时发现并发症并指导临床进行及时处理。
【关键词】超声引导；肾脏组织活检；并发症
The clinical followup value of percutaneous renal biopsy under ultrasound guidance TANG Shijun， ZHANG Zhenling， ZHOU Hong. Department of Ultrasound， The Third Peoples Hospital of Chengdu，Chengdu 610031, China
【Abstract】 Objective To explore the application and postoperative followup value of percutaneous renal biopsy under ultrasound guidance. Methods The achievement ratio, complications incidence when 24 hours and 48 hours ultrasound followup, causes of complications were analyzed to 46 patients received renal biopsy. Results In 46 cases (134 needles) the achievement ratio was 96% (129/134). After 24 hours of ultrasonography in the followup of the incidence of complications was 26% (12/46),with 1 case of severe complications,11 cases of mild complications. The complications included 8 cases of small perirenal hematoma, 3 cases of large perirenal hematoma,and 1 case of both great perirenal hematoma and abdominal hemorrhage.After 48 hours of ultrasonography in the followup of the incidence of complications was 30% (14 / 46).Compared with 24 hours ultrasound followup mainly small perirenal hematoma increased in 2 cases,a total of 10 cases,the case of both great perirenal hematoma and abdominal hemorrhage,increasing the amount of abdominal hemorrha. Conclusion Percutaneous renal biopsy under ultrasound guidance is a safe and effective method in diagnosis and management of renal diseases with less complications.As an invasive interventional operation, a variety of reasons may lead to complications.Therefore, the routine postoperative ultrasound followup is important,especially after 24 hours of ultrasound followup,able to timely detect complications and to guide clinical conduct a timely manner ......
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