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1、234中华超声影像学杂志2000年4月第9卷第4期ChinJUltrasonogr,April2000,Vol9,No.4临床研究超声引导经皮肾穿刺活检方法的改进陈伊伦陈芬胡志强王慧萍摘要!目的改进肾穿刺方法,以减少肾穿刺的并发症,提高标本质量。方法将100例有肾穿刺适应症的患者随机分成3组,均在B超引导下用穿刺枪取材。A组:定位于右肾下极外侧,略偏近髓质,垂直进针;B组:定位于右肾下极外侧皮质为主的部位,垂直进针;C组:定位于右肾下极外侧,靠近肾外缘处,穿刺时针略向内倾
2、斜,针尖对准肾皮质较厚的部位。结果每厘米肾组织中肾小球个数C组最多,B组次之,A组最少。穿刺的成功率三组相似。血尿的发生率A组最高,B组次之,C组最小。结论在应用活检枪的基础上,通过超声仪选择合适的穿刺位点及准确的导向对减少并发症,提高标本质量起决定性的作用。C组的穿刺方法每厘米肾小球个数最多,血尿发生率最低。关键词!超声检查;肾;活组织检查,针吸Studyontechnologicalimprovementbyultrasoundguidedpercutaneousrenalbiopsy
3、CHENYilun,CHENFen,HUZhiqiang,etal.DepartmentofInternalMedicine,theFirstAffiliatedHospitalofZhejiangMedicalUniversity,Hangzhou310003,ChinaAbstract!ObjectiveToimprovethemethodofpercutaneousrenalbiopsyfordecreasingthecomplicationsandamelioratingthesam
4、plequality.MethodsOnehundredpatientswhohadanindicationofperformingtherenalbiopsyweredividedintothreegroupsandverticallypuncturedunderultrasoundguidedbyabiopsyguntoobtainasamplefromtheexteriorsideofthelowerareaoftherightkidney,neartherenalmedulla(gro
5、upA)andtheareawheretherenalcortexwasthicker(groupB)andnearthevergeofthekidney,theneedlewastitledslightly,aimedthetipoftheneedleattheareawheretherenalcortexwasthicker.(groupC),respectively.ResultsThenumberofglomerulusofpercentimetrerenaltissuewasthemo
6、stingroupC,themediuminguoupB,andtheleastingroupA.Therateofsuccessfulpuncturewassimilarinthethreegroups.TheincidenceofhematuriaoccuredofterrenalbiopsywasthehighestingroupA,themediumingroupB,andthelowestingroupC.ConclusionsUsingabiopsygun,selectingasui
7、tablepuncturepointandtheaccuratedirectionimprovingguidedbyultrasoundinstrumentareimportantindecreasingthecomplicationsafterrenalbiopsyandimprovingthesamplequality.GroupCshowedthemostnumberofglomerulusandthelowestrateofhematuriaoccuredafterrenalbiopsy.
8、Keywords!Ultrasonography;Kidney;Biopsy,needle肾穿刺活检不但对肾脏病学的发展作出了重大贡资料与方法献,而且在临床工作中对肾脏病的诊断、治疗及预后判[1]断也极有意义。但经皮肾穿刺活检是一种创伤性检一、病例选择及穿刺定位方式查,可发生多种并发症,特别是出血并发症目前仍时有选择有肾穿刺适应证的患者随机分成3组。[2,3]发生。又由于各患者的肾脏高度、厚度、活动度差A组:共20例,男性15例,女性5例。年龄13~异较大,有时可导致穿刺失败
