施杰, 张璟, 刘伟. 206例经皮穿刺肾活检出血相关并发症的临床分析[J]. 临床肾脏病杂志, 2018, 18(7): 413-416. DOI: 10.3969/j.issn.1671-2390.2018.07.006
    引用本文: 施杰, 张璟, 刘伟. 206例经皮穿刺肾活检出血相关并发症的临床分析[J]. 临床肾脏病杂志, 2018, 18(7): 413-416. DOI: 10.3969/j.issn.1671-2390.2018.07.006
    SHI Jie, ZHANG Jing, LIU Wei. Clinical analysis of 206 cases of hemorrhage complications after percutaneous renal biopsy[J]. Journal of Clinical Nephrology, 2018, 18(7): 413-416. DOI: 10.3969/j.issn.1671-2390.2018.07.006
    Citation: SHI Jie, ZHANG Jing, LIU Wei. Clinical analysis of 206 cases of hemorrhage complications after percutaneous renal biopsy[J]. Journal of Clinical Nephrology, 2018, 18(7): 413-416. DOI: 10.3969/j.issn.1671-2390.2018.07.006

    206例经皮穿刺肾活检出血相关并发症的临床分析

    Clinical analysis of 206 cases of hemorrhage complications after percutaneous renal biopsy

    • 摘要: 目的 探讨经皮穿刺肾活检术加用止血药能否有效降低出血并发症。方法 收集安庆市立医院2010年1月至2017年8月行肾穿刺活检的病例206例,其中应用止血药物者101例(病例组),未应用止血药物者105例(对照组),进行性别、年龄匹配。分析2组患者肉眼血尿及严重出血并发症(肉眼血尿基础上需要输血、出现明确的动静脉瘘或需要行选择性肾动脉介入栓塞术)的发生情况,进行统计学分析,比较病例组和对照组出血发生率的差异。结果 病例组有4例出现肉眼血尿(IgA肾病1例、特发膜性肾病1例、系膜增生性肾小球肾炎1例、肾脏淀粉样变1例),其中行红细胞输注1例,行选择性肾动脉介入栓塞术1例;对照组有6例出现肉眼血尿(IgA肾病2例、特发膜性肾病1例、肾小球微小病变1例、狼疮肾炎1例、肾脏淀粉样变1例),其中行红细胞输注2例,出现动静脉瘘2例,行选择性肾动脉介入栓塞术1例。与对照组相比,病例组的肉眼血尿发生率(3.96% vs 5.71%,P=0.748)和严重出血并发症发生率(1.98% vs 4.76%,P=0.446)均降低,但差异无统计学意义。结论 肾穿刺活检常规应用止血药物并不能减少肉眼血尿以及严重出血并发症的发生率。

       

      Abstract: Objective To investigate whether hemostatic drugs can effectively reduce hemorrhage complications during the time of percutaneous native renal biopsy.Methods 206 cases undergoing percutaneous native renal biopsy in our department were collected in the period of 2010.1-2017.8. 101 cases were treated with hemostatic drugs (case group), and 105 cases were not treated with any hemostatic drugs. We matched sex and age, and observed the morbidity rate of gross hematuria and severe hemorrhage complications (gross hematuria given red blood cell transfusion, obvious renal arteriovenous fistula, or selective renal artery embolization) in 2 groups. The difference in hemorrhage complications between case group and control group was compared statistically. Results Four cases in case group had gross hematuria (1 case of IgA nephropathy, 1 case of idiopathic membranous nephropathy, 1 case of mesangial proliferative glomerulonephritis and 1 case of renal amyloidosis). Among them, 1 case was given transfusion of red blood cells, and 1 case selective renal artery interventional embolization. Six cases in control group had gross hematuria (2 cases of IgA nephropathy, 1 case of idiopathic membranous nephropathy, 1 case of minimal change glomerulopathy, 1 case of lupus nephritis and 1 case of renal amyloidosis). Among them, 2 cases were given transfusion of red blood cells, 2 cases had arteriovenous fistula, and 1 case was given interventional embolization. The incidence of gross hematuria and severe hemorrhage complications in case group was lower than that in control group (3.76% vs. 5.71%, P=0.748; 1.98% vs. 4.76%, P=0.446).Conclusions Application of conventional hemostatic drugs in percutaneous native renal biopsy did not reduce the incidence of gross hematuria and severe hemorrhage complications.

       

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