肾移植及移植后的血管并发症  

Vascular complications during and after renal transplantation

作　　者：陈卫国[1] 周鹏[1] 李晓伟[1] 周婷婷[1] 王庆堂[1] 王亮[1] 杨航[1] 李沙丹[1] 

机构地区：[1]解放军成都军区总医院泌尿外科,四川省成都市610083

出　　处：《中国组织工程研究》2015年第15期2394-2398,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:尽管肾移植手术技术已相当成熟,但各移植中心难免会出现术中及术后的血管并发症。目的:分析肾移植过程中及移植后血管并发症的诊断与处理。方法:回顾性分析11例肾移植过程中、移植后血管并发症资料。移植过程中并发症:动脉吻合口狭窄2例,肾静脉横断1例,髂外动脉硬化斑块剥脱堵塞肾动脉3例,移植肾静脉扭曲1例;移植后并发症:肾外型假性动脉瘤2例,吻合口狭窄1例,移植肾动脉压迫梗阻1例。结果与结论:肾移植中吻合口狭窄2例移植后恢复良好,分别于移植后6年及11年移植肾失功;肾静脉横断1例随访12年移植肾失功;髂外动脉硬化斑块剥脱堵塞肾动脉3例,1例移植肾当即失功,另2例分别随访6年及2年,现移植肾功能良好;移植肾静脉扭曲1例移植后出现移植肾功能延迟恢复,1个月后因重症肺部感染死亡。移植后发生的血管并发症中肾外型假性动脉瘤2例移植肾均失功;吻合口狭窄1例经置入支架后肾功能恢复正常,已随访18个月;移植肾动脉压迫梗阻1例移植后出现移植肾功能延迟恢复,3周后因重症肺部感染死亡。结果说明肾移植过程中及移植后发生血管并发症,只要诊断准确、处理及时,可取得比较满意的治疗效果。BACKGROUND： Although the renal transplantation technology has been quite mature, vascular complications during and after transplantation inevitably occur. OBJECTIVE： To investigate the diagnosis and management of vascular complications during and after renal transplantation. METHODS： A retrospective analysis was performed in 11 patients suffering from vascular complications during and after renal transplantation. During the transplantation, there were two cases of arterial anastomotic stenosis, one case of renal vain transverse, three cases of atherosclerosis plaque of the external iliac artery blocking the transplant renal artery, one case of twisted renal vein. After transplantation, there were two cases of extra renal pseudoaneurysm, one case of arterial anastomotic stenosis, and one case of renal artery obstruction. RESULTS AND CONCLUSION： Two cases of arterial anastomotic stenosis during operation had good recovery, and renal allograft dysfunction occurred after 6 and 11 years, respectively. In the case of renal vain transverse, the renal allograft functioned for 12 years. Among the three cases of atherosclerosis plaque of external iliac artery blocking the transplant renal artery, 1 case presented with renal allograft dysfunction immediately, the other two patients,renal function recovered well during the follow-up of 6 and 2 years respectively. In the case of twisted renal vein, delayed graft function occurred, and the patient died of severe pulmonary infection 1 month later. The renal allograft dysfunction occurred in the two cases of post-transplantation extra renal pseudoaneurysm. The case of post-transplantation arterial anastomoticstenosis was treated by balloon angioplasty and metallic stent placement via femoralartery, and the renal function became normal during 18 months of follow-up. The case of post-transplantation renal artery obstruction appeared to have delayed graft function, and died of severe pulmonary infection 3 weeks later. These findings indicate that patients with vascular comp

关 键 词：肾移植 血管 肾机能不全 组织构建 移植 并发症 肾功能衰竭 

分 类 号：R318[医药卫生—生物医学工程]