同种异体肾移植术后移植肾动脉狭窄介入治疗的临床疗效分析  

Clinical efficacy of interventional therapy for transplant renal artery stenosis after allograft renal transplantation

作　　者：谭小云[1] 陈德基[1] 何明基[1] 申刚[1] 李汉文[1] 王广宇[1] 

机构地区：[1]广州医学院第二附属医院放射科,广东广州510260

出　　处：《中国介入影像与治疗学》2010年第2期128-132,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨同种异体肾移植术后移植肾动脉狭窄(TRAS)介入治疗的临床疗效。方法介入治疗同种异体肾移植术后TRAS患者22例,其中单纯球囊扩张治疗10例(球囊组),内支架治疗12例(支架组)。对所有患者术前及术后2年内血压、肾功能以及生活质量进行评估,并与同期接受单纯药物治疗的6例TRAS患者(药物组)进行比较。结果球囊组技术成功率90.00%,支架组技术成功率100%。术后在血压及肾功能改善方面,球囊组和支架组均取得显著疗效,两组近期疗效未见明显差异,药物组疗效不满意。术后随访6个月～2年,支架组再狭窄率16.67%,除1例不明原因治疗无效外,其余11例均能比较健康的生活和工作。球囊组手术失败1例,再狭窄率达40.00%。结论内支架植入术可作为TRAS特别是I型及Ⅱ型狭窄的首选治疗方法。Objective To explore the clinical efficacy of interventional therapy for transplant renal artery stenosis（TRAS） after allograft renal transplantation.Methods Twenty-two patients with TRAS were treated with interventional therapy,including 10 patients（balloon group） underwent percutaneous transluminal angioplasty（PTA） and 12 patients（stent group） underwent stent implantation.The blood pressure,renal function and quality of life were recorded before and after interventional therapy within two years.Besides,two groups were compared with another group of 6 patients（medicine group） receiving medical treatment only.Results The technical success rate was 90.00% for PTA and 100% for stent implantation.The interventional treatment of TRAS with PTA or stent implantation was associated with significant improvement in blood pressure and renal function,while the conservatively medical treatment of TRAS was inefficient.There was no statistical difference in the short-term improvement of blood pressure or renal function between balloon group and stent group.Six to twenty-four-month follow-up indicated that there were 2 patients with restenosis（2/12,16.67%） in stent group.The total restenosis rate for PTA was 40.00%.Eleven patients in stent group achieved normal daily activities and works,except one was treated ineffectively with an uncertain cause.Conclusion Stent implantation for TRAS,especially for TRAS of type I and Ⅱ,can be used as the primary therapy.

关 键 词：移植肾动脉狭窄 介入治疗 支架 球囊 

分 类 号：R699.2[医药卫生—泌尿科学]