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目的评估导致B超引导下经皮自体肾活检后出血(PBB)的危险因素。方法回顾性分析了2005年1月～2006年12月在我院肾内科行B超引导下经皮自体肾活检的1262例患者的临床资料。结果PBB发生率为30.3%,其中,血肿和肉眼血尿发生率分别为29.4%和1.3%。轻、中和重度出血发生率分别为21.4%、8.4%和0.6%。7例肾活检后重度出血患者中,1例为IgA肾病(Lee氏分级V级),5例为狼疮性肾炎,1例为硬皮病肾危象。危险因素分析提示女性和年轻患者出血的风险更高。结论长期风湿免疫性疾病患者更易发生肾活检后严重出血,对此类患者术后宜密切观察。
Objective To assess the risk factors for B-ultrasonography-induced bleeding after percutaneous autologous renal biopsy (PBB). Methods The clinical data of 1262 patients undergoing percutaneous autologous renal biopsy guided by B-ultrasound in our department from January 2005 to December 2006 were retrospectively analyzed. Results The incidence of PBB was 30.3%, of which the incidence of hematoma and gross hematuria was 29.4% and 1.3% respectively. The rates of mild, moderate and severe bleeding were 21.4%, 8.4% and 0.6% respectively. Of the 7 patients who had severe bleeding after renal biopsy, 1 was IgA nephropathy (Lee’s grade V), 5 were lupus nephritis, and 1 was a scleroderma renal crisis. Risk factor analysis suggests that women and young patients have a higher risk of bleeding. Conclusion Patients with long-term rheumatic autoimmune diseases are more likely to have severe bleeding after renal biopsy, and these patients should be closely observed after surgery.