肾移植围术期少尿的血液透析治疗

Hemodialysis treatment for oliguric patients during kidney transplantation

目的:总结异体肾移植围术期少尿患者血液透析治疗效果。方法:我院自1995年5月～2005年5月行异体肾移植术,围术期少尿或无尿患者34例,给予血液透析及调整免疫抑制剂,抗炎、川芎嗪等治疗。结果:移植肾术后早期少尿或无尿患者原因,急性排斥反应55.9%,急性肾小管坏死38.2%,加速排斥反应5.9%。肾功能恢复31例,治愈率91.1%,3例移植肾切除,死亡1例,死亡原因是加速排斥反应。尿量恢复时间,最短术后7d,最长术后5个月,急性肾小管坏死组尿量恢复(15.4±8.3)d,急性排斥组尿量恢复(25.7±4.3)d。结论:合理血液透析治疗可减少并发症,提高人/肾治愈率,避免肾功能延迟恢复。

Objective To summarize the treatment effect of hemodialysis on oliguric patients during xenogenic kidney transplantation. Method 34 oliguric or anuric patients in the period of xenogenic kidney transplantation who was in-hospital between May 1995 and May 2005 were given hemodialysis, immunosuppressive agent, antiinflammatory drug, ligustrazine and so on. Results The reasons that led to oliguria or anuria early after transplantation were acute rejective reaction （55.9%）, acute renal tubular necrosis （38.2%） and accelerated rejective reaction （5.9%）. After kidney transplantation, 31 cases＇ kidney function recovered and the cure rate was 91.9%, 3 cases of transplanted kidney excised and 1 case died with the reason of accelerated rejective reaction. The urine volume recovery time were from 7 days to 5 months and in the acute renal tubular necrosis group was （15.4±8.3） days, in the acute rejection group was （25.7±4.3） days. Conclusion Reasonable hemodialysis treatment can reduce complications, improve the cure rate of human/kidney and avoid delayed recovery of kidney function.