Analysis Of Risk Factors For Complications Of Hematoma After Percutaneous Renal Biopsy Guided By Ultrasound

Objective Retrospectively analyze the complications of hematoma after percutaneous renal biopsy,and discuss the risk factors of their occurrence,so as to provide clinical evidence for preoperative risk assessment of patients undergoing renal biopsy.Methods A total of 766 patients who underwent percutaneous renal biopsy in the Department of Nephrology of Affiliated Jiangmen Traditional Chinese Medicine Hospital of Jinan University Hospital from January 2007 to December 2019 were selected and divided into four groups according to the size of postoperative hematoma: no hematoma,small hematoma,moderate hematoma,and large hematoma.Collect clinical data of patients in each group including age,gender,weight,history of hypertension,blood pressure at admission,preoperative laboratory test indicators(hemoglobin and platelet count,serum creatinine and serum urea nitrogen,prothrombin time,activation Partial thromboplastin time and plasma fibrinogen),kidney ultrasound measurement of length,blood pressure during operation,and pathological type of kidney tissue after operation.SPSS23.0 statistical software was used to first conduct analysis of variance,chi-square test,rank sum test and other single-factor analysis of the four groups of patients with complications,and then screen for variables with P ? 0.1 and clinicallyrelevant indicators into the multi-order logistic Regression analysis to determine the independent risk factors affecting the occurrence of hematoma of different degrees after percutaneous renal biopsy.Result 1.Among the 766 renal biopsy patients enrolled,345 patients(45.0%)had hematoma complications,including 216 patients(28.2%)with small hematoma and 103 patients(13.4%)with moderate hematoma and 26 patients(3.4%)with large hematoma.2.Clinical data of four groups of patients with no,small,medium and large hematoma complications: univariate analysiss results reveals that patients with different degrees of hematoma complications at age(F =8.894,P <0.001),history of hypertension(? 2 = 37.572,P <0.001),Preoperative Scr(H = 53.855,P <0.001)and preoperative e GFR(H =62.484,P <0.001)were statistically significantly different between the whole group.3.Univariate analysis of postoperative pathological types of patients with no,small,medium and large hematoma complications: patients with different degrees of hematoma complications have only Ig A nephropathy(?2 = 15.590,P = 0.001)in the pathological type illustrate a significant statistical significance,and the remaining pathological types have no statistical difference between the four groups.4.Multiple logistic regression analysis showed that: hypertension(OR =1.660,OR95% CI = 1.150 ? 2.398,P = 0.007);preoperative estimatedglomerular filtration rate(OR = 0.991,OR95% CI = 0.984 ? 0.998,P =0.009);renal pathology type Ig AN(OR = 3.303,OR95% CI = 2.347 ?4.647,P <0.001)were the independent risk factor for hematoma complications after percutaneous renal biopsy.Conclusion 1.The complications of hematoma after percutaneous renal biopsy are common,but most of them are small hematoma required no intervention.The overall incidence of complications of medium and large hematoma is relatively low.It is a relatively safe technique to obtain renal tissue pathology clinically.2.Combining history of hypertension,preoperatively estimated glomerular filtration rate level and renal tissue pathology type Ig A nephropathy are independent risk factors for hematoma complications after percutaneous renal biopsy.