CAJ | 학술논문

目的：探讨老年肾脏病患者行经皮肾穿刺活检术的安全性。方法前瞻性观察245例老年肾脏病患者在B超引导下采用BARD Magnum全自动活检枪和巴德活检针（MN1820）行肾活检的并发症并与250例非老年成人对照。结果（1）全部患者均取到肾小球，两组患者穿刺针数、取出肾组织长度及标本满意率均无明显差异（P＞0.05）。（2）无一例患者出现严重并发症，观察到的主要并发症是肾周血肿、腰痛和肉眼血尿，老年组和对照组比较均无明显差异（P＞0.05）。肾周血肿主要是小血肿，发生时间主要在24h内，肉眼血尿的发生时间主要在8h内。（3）穿刺针数增加是肾周血肿的危险因素，取出肾组织较长是肉眼血尿的危险因素。结论老年肾脏病患者肾活检术后并发症的发生率并不高于非老年肾脏病患者，充分的术前准备、提高肾活检操作技术水平和加强术后尤其是24h内的监测是保证老年患者肾活检安全的关键。
목적：탐토노년신장병환자행경피신천자활검술적안전성。방법전첨성관찰245례노년신장병환자재B초인도하채용BARD Magnum전자동활검창화파덕활검침（MN1820）행신활검적병발증병여250례비노년성인대조。결과（1）전부환자균취도신소구，량조환자천자침수、취출신조직장도급표본만의솔균무명현차이（P＞0.05）。（2）무일례환자출현엄중병발증，관찰도적주요병발증시신주혈종、요통화육안혈뇨，노년조화대조조비교균무명현차이（P＞0.05）。신주혈종주요시소혈종，발생시간주요재24h내，육안혈뇨적발생시간주요재8h내。（3）천자침수증가시신주혈종적위험인소，취출신조직교장시육안혈뇨적위험인소。결론노년신장병환자신활검술후병발증적발생솔병불고우비노년신장병환자，충분적술전준비、제고신활검조작기술수평화가강술후우기시24h내적감측시보증노년환자신활검안전적관건。
Objective To evaluate the safety of renal biopsy in elderly patients with renal disease. Methods A prospective observation of complications was performed in 245 elderly patients who received percutaneous renal biopsy with BARD Magnum biopsy gum and BARD MN1820 biopsy needle, and compared with those of 250 non elderly adult patients. Results (1)The renal biopsies were successfully taken in all patients. There were no significant difference in the frequency of puncture, length of the renal tissue and the specimen satisfactory rate between the two groups (P>0.05). (2)No serious complication occurred in all cases. Mild complications such as perirenal hematoma, lumbago and gross hematuria were observed after biopsy, showing no significant differ-ence between the two groups (P>0.05). Perirenal hematoma mostly occurred within 24h and gross hematuria occurred within 8h. (3)Increased frequency of puncture was risk of perirenal hematoma and increased length of the renal tissue was risk of gross hematuria. Conclusions There is no increased incidence of complications after renal biopsy in elderly patients with renal disease when compared with that of non elderly adult patients. To ensure the safety of renal biopsy, the key point is preparing before biopsy fully, improving the operative technique and strengthen monitoring after biopsy especially within 24h.