肾移植术后尿路上皮癌42例分析  

Analysis of 42 cases of uroepithelial tumors in kidney transplantation recipient

作　　者：赵国华[1] 董隽[1] 马鑫[1] 敖建华[1] 张旭[1] 洪宝发[1] 

机构地区：[1]中国人民解放军总医院泌尿外科,100038

出　　处：《中国急救复苏与灾害医学杂志》2010年第7期634-636,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨肾移植患者并发尿路上皮癌的临床特点。方法回顾性分析1977年～2009年8月间接受免疫抑制治疗（至少半年）的2159例肾移植患者中发生尿路上皮癌的病例。结果在2159例肾移植患者中，发生尿路上皮癌42例，发病率为1．9％。全部42例患者病例资料完整，所有患者均经术后病理证实为尿路上皮癌。35例（83．3％）患者因血尿就诊；7例（16．7％）患者体检时发现病情，其中包括2例无尿的患者。所有患者均接受手术治疗，术后辅以化疗及放疗。9例患者行开放的。肾根治性切除联合经尿道膀胱袖套状切除，住院时间17～32d，其中2例术后行床旁血滤；11例行后腹腔镜肾根治性切除联合经尿道膀胱袖套状切除术，住院时间13～19d；22例行经尿道膀胱肿瘤电切，住院天数0～10d。4例患者术后因广泛转移死亡。结论肾移植患者应该更加重视泌尿系常规检查，选择更少创伤的手术，尽可能的减少免疫抑制剂用量。Objective To analyze its clinical characters of urinary malignancies in patients with renal transplantation. Methods A retrospective analysis of 2,159 renal allograft who had taken immunosuppression for at least over six months was performed between 1977 and 2009 in The General Hospital of PLA. Results 42 cases of uroepithelial tumors were found in the 2,159 cases of renal transplantation （1.9%）, of which 35 diagnosed on account of hematuria（83.3%）, seven cases （16.7%） diagnosed by medical examination including two anuric patients. Surgery was performed on all the patients followed by chemotherapy or radiotherapy, in which the radical nephreetomy and transurethral cuffing cystectomy operation was applied on nine of them with being hospitalized in between 17 and 32 days; retroperitoneoscopic radical nephreetomy and transurethral cuffing cystectomy operation was applied on 11 of them with 13 to 19 days in hospital; TURBT operation was performed on 22 of them with 0 to ten days stay in hospital; four died of wide metastasis. Conclusion Urological routine examinations can be taken into account for patients with renal transplantation; the operation with fewer traumas is recommended. In addition, the reduced dosage of immunosuppressants is also recommended in order to maintain the normal function of the graft.

关 键 词：肾移植 尿路上皮癌 诊断 治疗 

分 类 号：R617[医药卫生—外科学]