16G和18G Cru—cut手动活检针超声定位肾活检的效果与安全性比较

目的：研究不同型号活检针对肾活检成功率及并发症的影响。方法将486例患者分成两组，16G组216例患者采用16 G Cru- cut手动活检针进行彩超引导下肾组织活检；18G组270例患者采用18 G Cru- cut活检针。16G活检针穿刺要求取材2条肾组织，18G活检针穿刺要求取材3条肾组织。结果两组活检总成功率94.44%。16G组活检成功率93.52%；平均穿刺次数（2.57±0.34）次；并发症发生率8.80%（肉眼血尿5.56%，肾包膜下血肿3.24%）。18G组活检成功率95.19%；平均穿刺次数（2.84±0.51）次；并发症发生率5.56%（肉眼血尿4.07%，肾包膜下血肿1.48%），两组成功率、并发症发生率均无统计学差异（均P＞0.05），两组穿刺次数有统计学差异（P＜0.01）。16G组光镜下平均肾小球数量（19.33±4.91）个；18G组光镜下平均肾小球数量（25.27±6.23）个；两组比较有统计学差异（P＜0.05）。结论使用18G针进行超声引导下肾活检，虽多取材1次，但与16G针比较不增加并发症。两种活检针取材的有效肾小球数量有差异，但均可保证光镜、电镜及免疫荧光检测的标本质量。

Comparison of 16G and 18G Tru-cut needles in percutaneous ultrasound-guided renal biopsy

Objective To compare the use of 16G and 18G biopsy needles in percutaneous ultrasound- guided renal biopsy. Methods Four hundred and eighty six patients undergoing percutaneous ultrasound- guided renal biopsy were as-signed to use 16G Cru- cut biopsy needle （n=216） or 18G needle （n=270）. Two specimens of renal tissue were required to be taken for 16G group and 3 specimens were required for 18G group. Results The overal success rate of biopsy was 94.4%, that was 93.6%in 16G group and 95.2%in 18G group （P〉0.05）. The average biopsy times in 16G group was 2.57±0.34 and that in 18G group was 2.84±0.51（P〈0.01）. The complication rate in G16 group was 8.80%（gross hematuria 5.56%, subcapsular renal hematoma 3.24%） and that in G18 group was 5.56%（gross hematuria 4.07%, subcapsular renal hematoma 1.48%） （P〉0.05）. The average number of glomerulum under light microscope in 16G group was 19.33 ±4.91and that in 18G group was 25.27±6.23 （P〈0.05）. Conclusion Ultrasound- guided renal biopsies using 18G Cru- cut biopsy needle does not increase the incidence of complications, although one more specimen need to be taken compared to using 16G. The specimens of renal tis-sue taken using both needles meet standard of light, immunofluorescence and electron microscopic examinations.