经皮肾活检(PRB)是主要的活检技术,在中国被16G针或18G针使用,但两种不同直径的效果和安全性存在争议。这项研究旨在比较充分性,使用18G时的并发症发生率和病理分类16G针在中国人的本地肾脏上进行超声引导下进行肾活检。
我们回顾性分析了肾小球的数量,足够的采样率,2011年1月至2017年5月使用18G或16G针头的270例患者的并发症发生率和病理分类,并验证针头规格是否影响疾病诊断。
总共进行了270例肾脏活检。其中,72个是用18G针头进行的,和198用16G针头进行。在光学显微镜下使用18G相对于16G针的肾小球数量没有差异(24±11vs.25±11,p=0.265),而使用免疫荧光显微镜在16G组中发现的肾小球多于16G组(3±2vs.5±3,p<0.05)。18G组和16G组之间的适当采样率没有显着差异(90.28%vs.93.94%,p=0.298)。轻微的并发症,包括腰痛或腹痛的发生率(4.17%vs.7.07%,p=0.57),肉眼血尿(4.17%vs.3.54%,p=0.729),和无症状的肾周血肿(4.17%vs.1.52%,p=0.195),18G和16G组之间没有显着差异。在16G组中,2例发生严重并发症:严重肉眼血尿需要输血,腹膜后血肿需要手术治疗。18G组无严重并发症发生。尽管18G和16G组之间的严重并发症发生率没有显着差异(0%vs.1.02%,p=1)。
肾小球数量无显著差异,足够的采样率,或使用18G或16G针头进行肾活检时的并发症发生率,使用直径较小的18G针不影响IgA肾病和狼疮性肾炎的病理诊断或分类。
Percutaneous renal biopsy (PRB) is the primary biopsy technique and it was used by 16G needles or 18G needles in
China, but there is controversy about the effect and safety of the two different diameters. The study aims to compare the
adequacy, complication rate and pathological classification when using 18G vs. 16G needles to perform renal biopsy with ultrasound-guidedance on native kidneys in Chinese individuals.
We retrospectively analyzed the number of glomeruli, adequate sample rates, complication rates and pathological classification in 270 patients with the use of 18G or 16G needles from January 2011 to May 2017 and verified whether the needle gauge affected the disease diagnosis.
A total of 270 kidney biopsies were performed. Among them,72 were performed with 18G needles, and 198 were performed with 16G needles. There was no difference in the number of glomeruli under light microscope using 18G relative to 16G needles (24 ± 11 vs. 25 ± 11, p = 0.265), whereas more glomeruli were found in the 16G group than in the 16G group using immunofluorescence microscopy (3 ± 2 vs. 5 ± 3, p < 0.05). There was no significant difference in the adequate sample rates between the 18G group and the 16G group (90.28% vs. 93.94%, p = 0.298). Minor complications including the incidence of lumbar or abdominal pain (4.17% vs. 7.07%, p = 0.57), gross hematuria (4.17% vs. 3.54%, p = 0.729), and perinephric hematoma without symptoms (4.17% vs. 1.52%, p = 0.195), were not significantly different between the 18G and 16G groups. In the 16G group, 2 cases of serious complications occurred: severe gross hematuria requiring blood transfusion and retroperitoneal hematoma requiring surgery. No serious complications were observed in the 18G group, although there was no significant difference in serious complications rates between the 18G and 16G groups (0% vs. 1.02%, p = 1).
There was no significant difference in the number of glomeruli, adequate sample rates, or complication rates when using 18G or 16G needles to perform renal biopsy, and the use of an 18G needle with a smaller diameter did not affect the pathological diagnosis or classification of IgA nephropathy and lupus nephritis.