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肾活组织检查是诊断大多数肾实质病变的重要手段,而肾活组织标本一般是经皮穿刺肾脏获得。但这种穿刺操作要求病人血压正常、无出血性疾病以及肾脏不能太小,否则有可能并发肾周血肿甚至出血而需手术。经静脉肝活检对有严重出血疾病的病人是一项安全的检查操作,但作者在这种操作过程中,偶尔会无意把导管插到右肾静脉而非肝静脉,从而获取了肾活组织。由此促使作者在尸体上研究,把经静脉肝活检的器械改良成为适合作右肾活检之用。本文报道了应用这种改良器械作经颈静脉肾活检的结果。病人和方法对象为50例有明确指征需作肾活检的病人,其中18例血清肌酐>200μmol/L。因下列原因宜作经静脉而不宜作经皮肾活检:18例需要采取
Renal biopsy is an important tool for the diagnosis of most renal parenchymal lesions, whereas renal biopsy specimens are usually obtained by percutaneous puncture of the kidneys. However, this puncture requires patients with normal blood pressure, no bleeding disease and the kidneys can not be too small, or may be complicated by perirenal hematoma or even bleeding and surgery. Transvenous liver biopsy is a safe procedure for examining patients with severe bleeding disorders. However, during this procedure, the author occasionally inadvertently inserts a catheter into the right renal vein rather than the hepatic vein to obtain the renal biopsy. As a result, the author was prompted to study on the corpse and improve the device for transvenous liver biopsy to be suitable for use as a right renal biopsy. This article reports the results of a transjugular renal biopsy using this modified instrument. Patients and Methods Subjects: 50 patients with definite indications for renal biopsy, 18 of whom had serum creatinine> 200 μmol / L. Due to the following reasons should be made through the vein and not suitable for percutaneous renal biopsy: 18 cases need to be taken