公民逝世后器官捐献供肾移植受者移植肾动脉破裂的介入治疗四例  

Interventional treatment of transplant renal artery rupture of donation after citizens death： report of 4 cases

作　　者：王凯 曲青山 苗书斋 张彦选 蒋欣 梁韶峰 

机构地区：[1]人民医院肾脏移植科,郑州450003

出　　处：《中华器官移植杂志》2014年第8期492-495,共4页Chinese Journal of Organ Transplantation

摘　　要：目的探讨公民逝世后器官捐献（DCD）供肾移植受者移植肾动脉破裂的特点及介入治疗效果。方法总结2012年2月至2013年12月行DCD供肾移植28例的资料，其中术后发生移植肾动脉破裂4例，均采用经导丝置入腹膜支架进入假性动脉瘤或出血段释放的介入方法处理血管并发症，观察治疗效果。结果2例出现假性动脉瘤，介入治疗后肾功能恢复出院；另外2例移植肾切除术后，动脉残端破裂出血，经急诊介入治疗后封堵出血点，病情恢复稳定。结论I）CD供肾移植受者术后感染风险较大，部分移植肾局部感染侵蚀肾动脉，造成动脉破裂出血，介入治疗移植肾动脉假性动脉瘤和破裂出血具有创伤小、即时见效的优点，可作为开放手术的替代治疗方法。Objective To explore the characteristics and effects of interventional therapy of transplant renal artery rupture of donation after citizens death （DCD）. Method Among 28 cases of DCD renal transplantations （from February 2012 to December 2013）, the transplant renal artery rupture occurred in 4 cases. Vascular complications were treated with the guide wires to place stents in the pseudoaneurysms or bleeding period. Result Pseudoaneurysms occurred in 2 cases, and they were successfully discharged after interventional treatment. In the rest two patients, the artery residual ruptured and bled after the nephrectomy, and they recovered after interventional treatment to stop bleeding. Conclusion For kidney transplant recipients, the DCD postoperative infection is risky. Some transplant kidneys have local infection and erosion of renal artery, which causes arterial hemorrhage. The interventional treatment of transplant renal artery pseudoaneurysms and rupture bleeding has the advantages of small trauma and instant effect, and can be used as an alternative treatment of open surgery.

关 键 词：肾移植 动脉破裂 介入治疗 毛霉菌属 曲霉菌属 感染 

分 类 号：R699[医药卫生—泌尿科学]