肾活检技术与肾脏病理诊断规范PPT参考.pptVIP

肾活检技术和肾脏病理诊断规范  如何开展肾活检及肾脏病理工作 如何更好的开展肾活检及肾脏病理工作  肾穿刺的意义 病理类型 ■病变程度 制定治疗方案 了解患者的预后 原发病的诊断  慢性肾炎临床分型 隐匿性肾炎综合症 慢性肾炎综合症 急性肾炎综合症 肾病综合症 急进性肾炎综合症 可质性肾炎综合症  慢性肾小球肾炎病理分型 MCN MesPGN IgAN Non-IgAN FSGS MN MPGN ECPGN Crescent GN CIN/AIN  6  IgAN分型 I II IV V 肉眼血尿型 隐匿性肾炎型 慢性肾炎型 恶性高血压 肾病综合症 急进性肾炎  适应症 ■弥漫性肾脏病变 24小时蛋白尿 ■结缔组织病 移植肾 原因不明的急性肾衰  Urine Dip e for prolein If Orthostatic proteinuri Non-Orthostati (民 producible Proteinuria Discharge Repent Urine Dipstick I week later If both samples dipstick +ve If I of2 samples Dipstick +ve Persistent proteinuria ntermittent proteinuria Check Bp聚24hTUp Repeat Urine Dip stick e Renal function Check bp Urine f 是 Renal function in 6 months then yearly If TUP IF TUP ≥1 y/day OR Renal fulnction ontaneous Normal bp OR High BP to persistent Resolution of Proteinuria Proteinuria 6-12 monthlv Refer Nephrol Discharge follow. Consider rena Biopsy  UrinE dirties +re for blood Repeat Utne Dipstick If still +re for bltd. Do Urine FEME an fresh mid- stran i f5RBCs hpf and prowin-ve If25RBCshp and protem+ve If5 RBCshpf ad protein-ve Do Urine Phuse Contis Miscopy Check BP Reml ?unction Pedomhantly Mied Isomorphic Predsmhanly in s mendS OR High BI OR Abnomal CR SusPicio n of画 Reral funcion ooten ae OR Hich Bp Check 6-12 montI D \U, Cystoscopy Urine FEME BP Urine Cholo gy 复bw-p Phase co mast mrroscor Consider fumaligIany Real Bopsy stpes Prclein-Te Keter Urokyist