优化肾活检:超声引导切向入路的有效性和安全性。

Q3 Medicine
Radiologia Brasileira Pub Date : 2025-06-16 eCollection Date: 2025-01-01 DOI:10.1590/0100-3984.2024.0132-en
Rogério Augusto Pinto-Silva, Marcell de Barros Duarte Pereira, Milton Domingos Panzi Neto, Otton Lourenço de Lima Reis, Raquel Sadala Mendes, Gessilane Martins da Silva, David Campos Wanderley, Stanley de Almeida Araújo
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引用次数: 0

摘要

目的:介绍采用切线入路进行的一系列门诊肾活检的结果,并对患者安全性和获得足够材料的频率进行分析。材料和方法:本回顾性观察性研究对244例在单中心行超声引导肾活检的患者的病理结果和演变进行了分析。在每次活检中,针都在肾包膜下方的皮质中前进。病理学家检查碎片,计数获得的存活肾小球;必要时进行额外穿刺,只要多普勒超声显示无出血。患者一直在诊所休息,随访超声评估后出院,一周后联系以调查晚期不良事件。结果:10例患者被排除在分析之外,留下234例患者的样本。95.73%的诊断材料被认为是充分的,3.42%的诊断材料是部分充分的,0.85%的诊断材料不是很有代表性。2例(0.85%)出血大于50 cm3,转至医院急诊科。这两名患者都有良好的进展:一名患者只需要休息一段时间,另一名患者需要输血,手术后48小时出院。结论:切线肾活检具有较高的安全性和有效性,是肾脏和全身性疾病的可靠诊断工具,应作为获得足够病理标本的首选方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimizing renal biopsy: efficacy and safety of the ultrasound-guided tangential approach.

Objective: To present the results of a series of outpatient renal biopsies performed with a tangential approach, as well as to conduct an analysis focusing on patient safety and the frequency with which sufficient material was obtained.

Materials and methods: This retrospective observational study examined the pathology results and evolution of 244 patients referred for ultrasound-guided renal biopsy at a single center. In each biopsy, the needle was advanced in the cortex just below the renal capsule. The pathologist examined the fragments, counting the viable glomeruli obtained; additional punctures were performed if necessary, as long as Doppler ultrasound showed no bleeding. The patients remained at rest at the clinic, being discharged after a follow-up ultrasound evaluation and contacted one week later to investigate late adverse events.

Results: Ten patients were excluded from the analysis, leaving a sample of 234 patients. The material obtained for diagnosis was considered sufficient in 95.73% of the procedures, partially adequate in 3.42%, and not very representative in 0.85%. Two patients (0.85%) had bleeding greater than 50 cm3 and were referred to the hospital emergency department. Both of those patients had a favorable evolution: one required only a period at rest, and the other required a blood transfusion, being discharged 48 h after the procedure.

Conclusion: The tangential approach to renal biopsy, with its high rates of safety and efficacy, representing a reliable diagnostic tool for renal and systemic diseases, should be the method of choice for obtaining adequate pathological specimens.

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来源期刊
Radiologia Brasileira
Radiologia Brasileira Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
2.60
自引率
0.00%
发文量
75
审稿时长
28 weeks
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