肾移植后尿瘘的诊断与治疗  

Diagnosis and treatment of urinary fistula following kidney transplantation

作　　者：卓文利[1] 徐廷昭[1] 吴卫真[1] 杨顺良[1] 谭建明[1] 

机构地区：[1]解放军南京军区福州总医院全军器官移植中心,福建省移植生物学重点实验室,福建省福州市350025

出　　处：《中国组织工程研究与临床康复》2010年第5期765-768,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：解放军南京军区福州总医院泌尿外科是全军器官移植中心;福建省移植生物学重点实验室;2008年获福建省科技创新平台建设计划资助项目(2008J1006)~~

摘　　要：背景:在目前肾源奇缺的情况下,因尿瘘而导致移植肾切除者尤为可惜,尿瘘的合理诊治应引起器官移植工作者的高度重视。目的:探讨肾移植后尿瘘的临床诊断与治疗措施。方法:对解放军南京军区福州总医院全军器官移植中心收治的16例肾移植后尿瘘病例资料进行回顾性分析。结果及结论:尿瘘发生率为1.26%,13例单纯性尿瘘行保守治疗,保守治疗成功11例,2例因输尿管远端坏死保守治疗失败,行移植肾输尿管膀胱再吻合及带蒂大网膜修补后治愈,尿瘘保守治疗成功率84.6%;3例复杂性尿瘘患者采用带蒂大网膜移植修补,均1次手术成功。结果提示,对于肾移植后尿瘘患者应高度重视和积极治疗,早期诊断,选择正确治疗措施是救治成功的关键,利用大网膜的生物学特性,采用带蒂大网膜修补肾移植后复杂性尿瘘和单纯性尿瘘保守治疗失败后病例具有取材方便、组织修复快、尿瘘复发率低的特点,适于临床推广应用。BACKGROUND：Presently,the kidney source is limited.Urinary fistula-induced nephrectomy of transplanted kidney is regrettable.Reasonable diagnosis of urinary fistula should be paid great attention by workers of organ transplantation.OBJECTIVE：To study the diagnosis and treatment of the urinary fistula in kidney transplantation patients.METHODS：The clinical data of 16 patients with the urinary fistula following kidney transplantation,who was recruited from the Organ Transplantation Center,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA,were retrospectively analyzed.RESULTS AND CONCLUSION：The morbidity of the urinary fistula following kidney transplantation was 1.26%,the conservative treatment were used to 13 cases of simple urinary fistulas,11 of 13 cases were successful（84.6%）.2 case failed（15.4%）,pedicled omentum grafts were successful used to treat 3 cases of complex urinary fistulas after renal transplantation by one operation.Intensive care and active measures should be given to the urinary fistula patients after kidney transplantation.The key to the successful treatment involved with the diagnosis in early stage and the correct measures.With biological characteristics of omentum,applying pedicled omentum grafts to repair complex urinary fistulas and simple urinary fistulas which were failure of the conservative treatment after renal transplantation has advantages as followings,convenient to draw material,recovering tissue quickly and low recurrence rate.It is fit for clinic.

关 键 词：尿瘘 肾移植 诊治 并发症 复发 

分 类 号：R617[医药卫生—外科学]