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在诊断肾移植急性排斥反应时,对移植肾进行穿刺活检是一常用方法,但这对移植肾及病人有一定的危险。较理想的活检术是要取得足够完整的肾皮质组织而又不损伤移植肾。现在大多是采用经皮穿刺活检术,该操作对移植肾的定位仍有一些不同的方法。作者介绍了采用实时超声定位引导穿刺针选择性地穿刺肾皮质而避免损伤肾髓质和肾门的操作方法。在进行穿刺活检前,患者舒张压应低于100mmHg,采用3.5MH2线阵扫描探头,选择一个便于操作的体位,探头在整个操作过程中由助手固定位置不变。局麻下切开皮肤、皮下,使用14号Tru Cut活检穿刺针,在B超引导下小心穿过肾纤维膜,通过纤维膜时有一定的阻力,这时活检针尖在超声扫描下可清晰地看
In the diagnosis of acute rejection of renal allograft, biopsy of the transplanted kidney is a commonly used method, but this has a certain risk for renal transplant recipients and patients. The ideal biopsy is to get enough intact renal cortical tissue without damaging the transplant kidneys. Now mostly using percutaneous biopsy, the operation of the positioning of the kidney transplant there are still some different ways. The author describes the use of real-time ultrasound positioning guide needle puncture the renal cortex selectively to avoid damage to the medulla and kidney door operation method. Before performing a biopsy, the diastolic blood pressure of the patient should be less than 100 mmHg. A 3.5 MH2 linear scan probe is used to select a position for easy operation. The probe is fixed by the assistant during the entire operation. Under local anesthesia, cut the skin, subcutaneously, using 14 Tru Cut biopsy needle, carefully guided through the renal fiber membrane under the B-ultrasound, there is a certain resistance through the fibrous membrane, then the biopsy needle in the ultrasound scan can be clearly Look