肾移植后髂内动脉自体移植治疗感染性髂外动脉出血(附一例报告及文献复习)

Management of external iliac artery mycotic hemorrhage after kidney transplantation by the use of hypogastric artery autograft (report of one case and review of literature)

目的探讨肾移植后感染性髂外动脉吻合口出血的处理。方法报告1例髂内动脉自体移植治疗肾移植后感染性髂外动脉吻合口大出血,结合文献复习讨论。患者,男性,25岁,肾移植术后20d、23d、37d3次出现感染性髂外动脉吻合口大出血,均得到及时处理,最后将感染病变严重的髂外动脉段切除,并以相应长度的髂内动脉段移植修复。结果开放后血流通畅,术后患者恢复顺利,患侧下肢血供良好,功能正常。结论介绍了肾移植术后感染性髂外动脉出血的各种处理方法,认为以自体髂内动脉移植修补缺损是合理可行,效果较好,操作简易的方法。

Objective To evaluate the treatment metheds of the external iliac artery mycotic massive hemorrhage after kidney transplantation. Methods Patient, male, 25, external iliac artery massive hemorrhage on the 20, 23, 37th days after kidney transplantation. The mycotic segment of the external iliac artery was dissociated and resected carefully. A segment of about 3cm hypogastric artery was interposed between the proximal and distal ends of the external iliac artery. Results The blood stream of the external iliac artery was straightway and the function of the suffered lower limb was returned to normal during the follow-up. Conclusion Management metheds of external iliac artery mycotic massive hemorrhage after kidney transplantation was reviewed.To resect the diseased mycotic segment and to repair the defect with an autograft of hypogastric artery is believed to be natural and effective.This new management strategy is highly recommended.