【摘要】 目的:探讨应用18 G活检针行超声引导下经皮肾穿刺活检术的有效性及安全性。方法:回顾性分析2015年1月—2020年6月汕头大学医学院第二附属医院和汕头市第二人民医院肾内科收治的210例行超声引导下经皮肾穿刺活检术患者的临床资料。根据穿刺针的直径分为18 G组(103例)和16 G组(107例)。比较两组的有效穿刺率、取材良好率、病理诊断结果、术后并发症发生率。结果:18 G组和16 G组穿刺组织标本在光镜下的肾小球数差异无统计学意义(分别为24.34±11.42和25.41±10.75,P>0.05),取材良好率差异也无统计学意义(分别为92.2%和94.4%,P>0.05)。18 G组与16 G组诊断的疾病谱差异无统计学意义(均P>0.05),两组中的IgA肾病患者的病理分型(Lee分级和牛津分型)差异也均无统计学意义(均P>0.05)。18 G组患者总的并发症发生率低于16 G组(分别为14.6%和36.4%,P<0.001),18 G组患者术后肾区疼痛发生率也低于16 G组(分别为2.9%和14.0%,P=0.04)。结论:18 G肾穿刺活检针在获取的肾小球数量、取材良好率方面与16 G活检针无差异,直径较小的18 G肾穿刺活检针也不会影响肾脏疾病的诊断及病理分型,而且并发症发生率较低。更多还原

【Abstract】 Objective: To investigate the effectiveness and safety of ultrasound-guided percutaneous renal biopsy with 18 Gauge(G) biopsy needles. Methods: The clinical data of 210 patients who underwent ultrasound-guided percutaneous renal biopsy admitted to the Department of Nephrology of the Second Affiliated Hospital of Shantou University Medical College and the Second People’s Hospital of Shantou from January 2015 to June 2020 were retrospectively analyzed. The patients were divided into 18 G group(103 cases) and 16 G group(107 cases)according to the diameter of the puncture needle. The effective puncture rate, good sampling rate, pathological diagnosis results, and postoperative complication rate were compared between the two groups. Results: There was no statistically significant difference in the number of glomeruli of the punctured tissue specimens under the light microscope in the 18 G group and the 16 G group(24.34±11.42 and 25.41±10.75, respectively, P>0.05), and the difference in the good rate of sampling was also not statistically significant(92.2% and 94.4%, respectively, P>0.05). There was no statistically significant difference in the spectrum of diseases diagnosed between the 18 G group and the 16 G group(all P>0.05), and the pathological types(Lee classification and Oxford classification) of patients with IgA nephropathy in the two groups were also not statistically significant(all P>0.05). The overall incidence of complications in the 18 G group was lower than that in the 16 G group(14.6% and 36.4%,respectively, P<0.001), and the incidence of postoperative renal pain in the 18 G group was also lower than that in the 16 G group(2.9% and 14.0%, respectively, P=0.04). Conclusion: The 18 G kidney puncture biopsy needles did not differ from the 16 G biopsy needles in terms of the number of glomeruli obtained and the good sampling rate, and the smaller diameter of the 18 G kidney puncture biopsy needles did not affect the diagnosis and pathological staging of kidney disease, and the complication rate was lower.更多还原