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不同穿刺针型号对肾穿刺术后出血风险的影响研究

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目的 研究不同型号的肾穿刺针对肾穿刺术后出血风险的影响。方法 采用回顾性分析,纳入2020年1月至2022年12月在重庆医科大学附属第三医院和重庆市九龙坡区人民医院住院行肾穿刺活检的患者428例作为研究对象,采用不同型号穿刺针,比较术后出血并发症(血肿、血尿)发生情况。结果 428例患者行肾穿刺术后出血并发症发生率为21。0%(90/428),其中血肿发生率为18。9%(81/428),血尿发生率为2。1%(9/428);血红蛋白(Hb)下降中位数为5 g/L,需要输血及介入治疗等严重并发症发生率为0。9%(4/428)。对采用不同型号肾穿刺针患者进行分组(16G组、18G组)比较,两组基线资料及肾脏病理类型分布差异无统计学意义(P>0。05)。16G组、18G组患者术后出血发生率分别为22。4%(52/232)、19。4%(38/196),其中血肿发生率分别为 20。7%(48/232)、16。8%(33/196),血尿发生率分别为 1。7%(4/232)、2。6%(5/196),Hb 下降分别为6(0,16)g/L、4(0,17)g/L,差异均无统计学意义(P>0。05)。两组需要输血治疗、介入治疗、Hb下降>10 g/L等严重并发症发生率比较,差异均无统计学意义(P>0。05)。结论 超声引导下肾穿刺活检术较为安全,严重并发症发生率低;不同穿刺针型号与术后出血风险无明显关系。
Effect of different puncture needle models on the risk of bleeding after renal puncture
Objective To study the effect of different types of renal puncture needles on the risk of bleeding after renal puncture.Methods A retrospective analysis was performed on 428 patients who under-went renal biopsy in the Third Affiliated Hospital of Chongqing Medical University and Jiulongpo District People's Hospital of Chongqing from January 2020 to December 2022.Different types of puncture needles were used to compare the occurrence of postoperative bleeding complications(hematoma,hematuria).Results The incidence of bleeding complications after renal puncture in 428 patients was 21.0%(90/428),of which the incidence of hematoma was 18.9%(81/428),the incidence of hematuria was 2.1%(9/428),the median decrease in hemoglobin(Hb)was 5 g/L,and the incidence of serious complications such as blood transfusion and interventional therapy was 0.7%(4/428).The patients with different types of renal puncture needles were grouped(16G group,18G group).There was no significant difference in baseline data and distri-bution of renal pathological types between the two groups(P>0.05).The incidence of postoperative bleeding in 16G group and 18G group was 22.4%(52/232)and 19.4%(38/196),respectively.The incidence of hema-toma was 20.6%(48/232)and 16.8%(33/196),respectively.The incidence of hematuria was 1.7%(4/232)and 2.6%(5/196),respectively.The decrease of Hb was 6(0,16)g/L and 4(0,17)g/L,respectively.There was no significant difference(P>0.05).There was no significant difference in the incidence of serious compli-cations such as blood transfusion,interventional therapy and Hb decrease>10 g/L between the two groups(P>0.05).Conclusion Ultrasound-guided renal biopsy is safe and has a low incidence of serious complica-tions.There was no significant relationship between different puncture needle types and postoperative bleeding risk.

renal puncturepuncture needle typebleedingultrasound guidance

郑卢权、陈小瑜、周嘉南、张小明、林利容、任姜汶

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重庆医科大学附属第三医院肾内科,重庆 401120

重庆市九龙坡区人民医院肾病风湿科,重庆 400050

肾穿刺术 穿刺针型号 出血 超声引导

重庆市技术创新与应用发展专项面上项目

cstc2019jscxmsxmX0166

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(4)
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