选择髂内或髂外动脉吻合对移植肾的影响

Comparison of transplanted kidney function and blood flow between the use of internal and external iliac arteries

目的探讨肾移植动脉重建选择髂外或髂内动脉时移植肾血流参数、肾脏功能和血管并发症的差异。方法135例初次肾移植患者随机分为2组,2组患者平均年龄、HLA错配数目、淋巴细胞毒试验、冷／热缺血时间差异均无统计学意义(P>0．05),术后免疫抑制剂应用方案相同。应用髂外动脉端侧吻合66例,髂内动脉端端吻合69例。随访3个月,比较2组患者肾脏功能、彩色多普勒肾脏血流参数和血管并发症发生率。结果髂内动脉、髂外动脉组2组患者术后3个月时肾功能监测指标(Cr:118．41 vs 123．68μmol／L),移植肾主肾动脉、段动脉、大叶间动脉血流及阻力指数差异无统计学意义(P>0．05)。结论肾移植动脉重建选择髂内外动脉对移植肾功能及血液流变学无明显影响,动脉选择应根据患者具体情况决定。

Objective To investigate if there are differences in transplanted kidney function,blood flow and artery complications between the use of internal and external lilac arteries. Methods In our center 135 renal transplant recipients were randomly divided into 2 groups,including 66 recipients using external lilac artery and 69 using internal lilac artery. There was no significant difference in patients＇ mean age,HLA mismatch number,lymphocytotoxicity test, cold/warm ischemic time between the 2 groups （ P 〉 0.05 ）. The postoperative immunosuppressive regimen was the same for the 2 groups. Renal function, blood flow parameters and artery complications were compared between the 2 groups at 3 months after operation. Results No statistical difference between the 2 groups in renal function （Cr： 118.41 μmol/L for internal vs 123.68 μmol/L for external lilac arteries） , and blood flow parameters by color Doppler ultrasonography was observed （P 〉 0.05 ）. Conclusions Using internal or external lilac artery has no difference in transplanted kidney function and blood flow. The artery should be individually selected for renal transplantation.