肾移植术后近期输尿管梗阻的病因分析和治疗

Analysis an cause and treatment of ureteral stenosis in early period after kidney transplantation

目的：分析肾移植术后近期内移植肾输尿管梗阻发生的原因和治疗手段。方法：总结我科1993年2月-2007年8月共250例肾移植患者，术后1—12周内发生输尿管梗阻导致移植肾积水共8例，占3．2％，其中2例血肿压迫；2例输尿管膀胱吻合口狭窄；1例输尿管过长扭转；1例移植肾旋转致输尿管扭转；1例吻合口漏；1例精索水肿压迫。结果：除1例吻合口漏患者保守治疗外，其余7例均再次手术解除梗阻，术后病情改善，移植肾功能恢复。结论：肾移植术后近期移植肾输尿管梗阻的原因多与外科因素有关；对手术各个环节加以注意，可以减少输尿管梗阻的发生。外科手术是解除术后输尿管梗阻的主要手段。

Objective：To analyze the cause and treatment of ureteral stenosis in the early stage after kidney transplantation. Methods：250 cases of the kidney transplantation since 1993 to 2007 were collected and analyzed, including 141 men and 109 women,240 cadaveric transplantations and 10 living dononr transplantations. Results：In 8 cases（3.2%） ureteral stenosis occurred in the early stage following the renal transplantation;including hematoma compression（ 2cases ）;stenosis of ureterbladder stoma（2cases） ; ureter torsion （1case） ;transplantal kidney torsion （1case） ; stomal leak （1case） and hydropsia of spermatic cord（lcase）, 7 cases required another surgical operation to remove the obstruction and the renal function recovered in these cases. Conclusion：The ureteral stenosis in the early stage of kidney transplantation was mostly contributed to the surgical reasons such as mis-perfamance. The occurance rate of ureteral stenosis should be reduced if each one step of the kidney transplantation is carefully performed. The open surgical managemen is a direct and effective method to remove the obstruction.