Renal puncture, also known as renal biopsy, is characterized by various types of renal diseases, complicated etiology and pathogenesis, and the clinical manifestations of many renal diseases are not completely consistent with the histological changes of the kidney. At this time, a kidney puncture is needed.

After micturition, the patient with renal puncture is prone on the examination table, and a pillow with a diameter of 10- 15 cm and a length of 50-6cm is placed on the abdomen, and the kidney is pushed to the back for fixation, with his arms extended forward and his head tilted to one side.

Generally, the right lower kidney is selected as the puncture point, with the puncture point as the center, the back skin is disinfected and a sterile towel is laid. Sterile B-ultrasound puncture probe imaging, local anesthesia with 1-2% lidocaine. A 10cm long intracardiac needle was inserted vertically into the renal capsule from the puncture point, and a small amount of local anesthetic was injected.

Puncture the puncture needle vertically into the renal capsule, and observe the horizontal movement of the kidney with breathing. When the lower pole of the kidney moves to the best puncture position, make the patient hold his breath, immediately and quickly puncture the puncture needle into the kidney for 2-3 cm, and pull out the puncture needle to guide the patient to breathe normally.

Check whether renal tissue is taken and measure its length. After observing more than 5 glomeruli under anatomical microscope, light microscope, electron microscope and immunofluorescence were sent. If there is no renal tissue, you can repeat the above steps. Generally, 2-3 times is appropriate.

Extended data:

The changes of renal histomorphology provide an important basis for clinicians to judge the condition, treat the disease and estimate the prognosis. It can be said that the development of renal pathological examination is a leap in the development of kidney disease.

The results of renal pathological examination have become the gold index for the diagnosis of renal diseases. To sum up, the clinical significance of renal puncture mainly includes the following points:

⑴ Definite diagnosis: The clinical diagnosis of patients above 1/3 can be corrected by renal biopsy.

⑵ Guided treatment: The clinical treatment plan of patients with nearly 1/3 can be modified by renal biopsy.

⑶ Prognosis evaluation: Renal biopsy can more accurately evaluate the prognosis of patients with renal diseases.

In addition, in order to understand the therapeutic effect or pathological progress (such as crescentic nephritis, lupus nephritis and IgA nephropathy, etc.). ), sometimes repeated renal pathological examination is needed.

In order to make a definite diagnosis, guide treatment or judge prognosis, and there is no contraindication to puncture, all kinds of primary, secondary and hereditary renal parenchymal diseases (especially diffuse lesions) in internal medicine can be punctured.

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