What Is a Renal Biopsy?

A kidney biopsy is usually called a kidney puncture. Due to the variety of kidney diseases, the etiology and pathogenesis are complicated, the clinical manifestations of many kidney diseases are not completely consistent with the histological changes of the kidneys. In order to clarify the pathology of the disease and further diagnose the specific disease of the patient, a renal biopsy is needed at this time!

Renal biopsy

A kidney biopsy is usually called a kidney puncture. Due to the variety of kidney diseases, the etiology and pathogenesis are complicated, the clinical manifestations of many kidney diseases are not completely consistent with the histological changes of the kidneys. In order to clarify the pathology of the disease and further diagnose the specific disease of the patient, a renal biopsy is needed at this time!

Chinese name

Renal biopsy

Alias

Renal puncture

Nature

With the development of science and technology

Definition

Consider whether secondary to systemic disease

In recent years, with the development of science and technology, the updating of imaging equipment and the improvement of operating skills, percutaneous renal biopsy technology has been widely developed. It can directly observe the changes in kidney morphology of kidney disease and can perform a series of observation . Due to the improvement of puncture technology, the application of immunohistochemistry and electron microscopy, the quality of its diagnosis has also been greatly improved. It has become an important means for the diagnosis, guidance and prognosis of kidney disease. Multiple

Understanding the changes in kidney morphology provides important evidence for clinicians to judge disease, treat disease, and estimate prognosis. It can be said that the kidney

1 Diet. Eat semi-liquid on the day of surgery, such as: pork congee, noodle soup, ravioli, minced meat, vegetable puree, steamed buns, etc., but you can't eat too full or fasting.

2 Posture training. Practice the posture you set during the operation, that is, the prone position, and place a small pillow on the abdomen.

3 Breathing exercises. Practice holding your breath after inhaling.

4 Intensify bed eating training. Prepare supplies for bed eating, such as straws and spoons. Eat on the bed 3 to 5 times.

5 Strengthen the training of urination in bed. Practice using the toilet 3 to 5 times.

6 Female patients cannot undergo kidney biopsy during menstruation.

7 Inform the family before surgery to accompany the patient on the day of surgery.

First, the doctor should introduce the basic knowledge of renal puncture to the patient before doing the renal puncture.

Second, the patient should understand the renal function before surgery, check the isotope kidney chart to understand the renal function, and make a B-ultrasonic to understand the size, location and right kidney activity of the kidney.

Third, check the patient's blood type for severe anemia.

Fourth, two days before kidney puncture surgery or intramuscular vitamin K, anticoagulant drugs should not be used a week before kidney puncture surgery.

V. Patients with acute renal failure should measure the thromboplastin time in addition to the prothrombin time before renal puncture. In addition to the number of platelets, check the platelet function from time to time. If abnormalities are found, they should be corrected before surgery . Platelet quantity and dysfunction can be transfused fresh platelets on the day of puncture. Prolonged bleeding time can be corrected by infusion of coagulation factor-rich cryoprecipitates.

Sixth, the patient should promptly check for complications after renal puncture. If complications occur, they should be dealt with in time.

1 The patient takes a prone position. A small pillow (about 10cm thick) is used for the abdominal pad to fully expose the puncture site of the lower back.

2 The patient cooperates with the doctor during the operation and pays attention to hold the breath.

3 The patient should relax as much as possible during the operation to avoid nervousness.

4 When going over the bed after puncture, the patient should avoid exerting force and relax the body as much as possible.

(1) General nursing

After renal biopsy of the patient, the local wound was pressed for several minutes, and then pushed into the ward by a flat cart.

Measure blood pressure and pulse every half an hour. After 4 hours, blood pressure can be stabilized and measurement can be stopped. If the patient's blood pressure fluctuates greatly or is low, it should be measured to a stable level and given symptomatic treatment.

After lying for 24 hours, if the condition is stable and there is no gross hematuria, you can go down to the ground. If the patient develops gross hematuria, the bed time should be extended until gross hematuria disappears or is significantly reduced. Intravenous hemostasis or blood transfusion if necessary.

After the patient was asked to drink more water, in order to expel a small amount of clot as soon as possible. At the same time, urine samples were taken 3 times for routine examination. You can eat normally without special circumstances after surgery.

During bedtime, the patient is instructed to rest quietly, reduce the movement of the body, and avoid causing bleeding from the wound. At the same time, the patient's wound should be carefully observed for bleeding and the life care should be strengthened.

The patient's vital signs should be closely observed, and if there is any complaint of discomfort, the abnormality should be handled in time.

(2) Nursing of complications

Hematuria: About 60 to 80% of patients have different degrees of microscopic hematuria, and some patients may have gross hematuria. In order to make a small amount of bleeding from the kidney as soon as possible, in addition to absolute bedridden, patients should be instructed to drink plenty of water. Changes in urine color to determine if hematuria is gradually increasing or decreasing. Patients with significant hematuria should be prolonged in bed, and be given intravenous hemostatic drugs in time, and blood transfusion if necessary.

Peri-renal hematoma: The patient should be absolutely bedridden within 24 hours after the renal biopsy. If the patient cannot tolerate, explain to the patient the importance of absolute bedridden and the possible complications of strenuous activities. To get the patient's cooperation. After 24 hours in bed without gross hematuria, begin to gradually move, do not suddenly increase the amount of activity to avoid rebleeding of wounds that have not fully healed. At this time, the patient's activities should be restricted, and appropriate care should be given in life. Patients with postoperative renal ultrasonography who have a hematoma around the kidney should be prolonged to bed. Low back pain and low back discomfort: Most patients have mild ipsilateral low back pain or low back discomfort, which usually lasts about 1 week. Most patients take general analgesics to reduce pain, but patients with peripheral kidney hematoma have severe back pain and can be given anesthetic painkillers. Abdominal pain and abdominal distension: Abdominal pain occurs after renal biopsy in individual patients, which lasts 1 to 7 days. A few patients may have tenderness and rebound pain. Due to the changes in living habits and the compression of the abdominal band, patients may drink a lot of water or may experience abdominal distension. Special treatment is generally not required. For those with obvious abdominal distension and abdominal pain, lactase and antispasmodics can be given to relieve symptoms.

Fever: Patients with peripheral renal hematoma may have moderate fever due to the absorption of hematoma. Care should be given to the fever patient and appropriate medication should be given.