The incidence of kidney disease has been increasing year by year in recent years, and due to the variety of kidney diseases, different diagnosis and treatment options need to be used for different diseases.
With the rapid development of medicine, percutaneous renal biopsy has become the main means of diagnosing and classifying kidney disease, guiding ** and judging the prognosis. The guidance of ultrasound can make this technique safer to implement.
Preoperative care:
1.Regulate the psychological pressure of the patient and make them actively cooperate with the operation. 2.Preoperative examination: blood routine, urine routine, coagulation function, infectious disease four items, to understand whether there is bleeding tendency; Ultrasound to understand the size, shape, position, and mobility of the kidneys, and to determine whether nephrocentesis is suitable for nephrocentesis.
3.Preoperative training: instruct the patient to perform "breath-holding" training, and perform "inhalation-stop" exercise in the prone position, that is, calm breathing and breath-holding at the end of inhalation, for about 1 min; Patients should be instructed to practice urination Xi bed, female patients can use the bedpan, and male patients can use urinals to prevent urinary retention caused by not urinating Xi the bed after surgery.
4.General observation: whether the patient has a cold or severe cough, renal puncture should be postponed for severe symptoms; Women should not undergo nephrocentesis during menstruation; If you have severe hypertension, control your blood pressure first; If the patient is using antiplatelet drugs, anticoagulant drugs, or proprietary Chinese medicines with the effect of invigorating blood circulation and removing blood stasis, the anticoagulant and antiplatelet aggregation drugs should be suspended before and after puncture. The diet should not be too full on the day of puncture, and it is not advisable to eat gas-producing foods such as soy products, pasta, and milk from the night before the operation, so as to avoid abdominal distension when lying in bed after puncture; Ask the patient to empty the stool before the puncture.
Modalities of kidney biopsy:
There are currently three types of kidney biopsy: ultrasound-guided percutaneous renal biopsy; Open surgical direct vision renal biopsy; Deep venipuncture renal biopsy. Ultrasound-guided percutaneous renal biopsy is the most widely used renal biopsy method in clinical practice due to its convenient and safe operation and high success rate of puncture.
Ultrasound-guided percutaneous renal biopsy is usually done under the guidance of ultrasound at the appropriate time, and the patient is placed in a prone position after urination, with arms folded around the bed and head tilted to one side. After local infiltration anesthesia, the surgeon inserts a renal puncture needle vertically into the kidney under the guidance of ultrasound in real time to quickly extract cylindrical kidney tissue, usually requiring 2-3 pieces of kidney tissue to be obtained.
The whole process can be completed within 5 minutes, and the patient needs to follow the doctor's instructions to inhale, hold and breathe normally in time to ensure the safe implementation of the operation.
Post-operative care:
1.The patient is instructed to stay in bed for 24 hours (lying flat for 6 hours can lie on the side), drink more water, closely observe blood pressure, pulse and three urine color changes and urine test, and continue ECG monitoring for 24 hours.
2.If the condition is stable and there is no persistent low back pain, abdominal pain, periumbilical pain and gross hematuria, the abdominal band can be removed after 24 hours and light activities can be started according to the situation. If there is blood in the urine, the bed stay should be prolonged. The patient should not do strenuous exercise within four weeks after surgery, and should avoid bending over, turning the waist and other waist force movements, so as to avoid re-bleeding of the wound that has not completely healed.
3.During the period of bed rest, give highly nutritious, easily digestible food, urinary retention, can be used to massage, listen to the sound of running water and other methods to induce urination, if the induction of urination is unsuccessful, catheterization can be used.
Ultrasound-guided renal biopsy is a minimally invasive, relatively convenient and safe clinical procedure, but it requires high professional skills of surgeons and care team. With the development of medicine, renal pathological examination has become the gold standard for the diagnosis of kidney diseases. Healthy Wintering Program