肾移植术后尿路梗阻的诊治体会  

Diagnosis and treatment of urinary obstruction following renal transplantation

作　　者：赵亚昆[1] 祝清国[1] 仇宇[1] 刘伟[1] 高治忠[1] 

机构地区：[1]哈尔滨医科大学附属第二医院泌尿外科,150086

出　　处：《临床外科杂志》2012年第4期274-275,共2页Journal of Clinical Surgery

摘　　要：目的 探讨肾移植术后尿路梗阻的原因,总结诊断和治疗经验.方法 回顾性分析我院1996年2月至2010年12月收治的14例肾移植术后尿路梗阻患者的临床资料.12例患者因血清肌酐进行性升高发现尿路梗阻,2例因尿瘘、尿外渗发现.均行开放手术治疗,术中发现输尿管末段狭窄,行输尿管膀胱吻合术.结果 所有患者移植肾功能于术后1～3周明显改善,移植肾积水于术后3～6周渐恢复.随访期间未见有尿路梗阻致移植肾积水.结论 尿路梗阻是肾移植术后严重并发症,加强围手术期管理,术中精细操作可有效预防其发生.超声和磁共振尿路成像对诊断有较大帮助.积极治疗可有效延长移植肾的存活,具有重要临床意义.Objective To explore the causes of urinary obstruction following renal transplanta- tion, and to summarize its diagnosis and management experience. Methods The clinical data of 14 urina-ry obstruction cases following renal transplantation between Feb. 1996 and Dec. 2010 were analyzed retro-spectively. Among them, 12 cases were found due to increased serum creatinine, and 2 were due to urinary fistula and urinous infiltration. All of them received open operation, during which stenosis was found in dis- tal ureter, ureter and bladder were anastomosed, a double J tube was placed in ureter. Results Renal function of the patients was improved in 1-3 weeks, and hydronephrosis returned to normal in 3-6 weeks. During the follow - up, no patients suffered hydronephrosis. Double J tube was removed 2 months later and the patients received interventional therapy drains urine from tube for long. Conclusion Urinary obstruction is a severe complication of renal transplantation. Emphasis on perioperative management and careful operation can help prevent it. Ultrasound and MRU are useful in early diagnosis. Of significant clin- ical importance, active treatment can help prolong survival of the allograft.

关 键 词：肾移植 尿路梗阻 诊断 治疗 

分 类 号：R692[医药卫生—泌尿科学]