肾移植术后移植肾假性动脉瘤的诊断与治疗(附2例报告)

Diagnosis and treatment of falseaneurysm in the allografted renal artery (Report of 2 cases)

目的：为提高肾移植术后移植肾假性动脉瘤的诊治水平。方法：回顾性调查771例肾移植患者术后发生肾动脉吻合口假性动脉瘤2例，并复习有关文献对其形成的原因、诊断与治疗予以讨论。结果：2例均发生于供肾动脉与受体骼外动脉吻合术后1～2个月，经彩色多普勒B超检查或动脉造影确诊。其中1例于移植肾骼总动脉造影后24h内突发假性动脉瘤破裂，通过床旁紧急手术止血抢救成功。另1例通过手术挽救了移植肾。结论：移植肾假性动脉瘤形成是多因素综合作用的结果。抗排斥反应、抗感染及提高手术技巧是预防移植肾假性动脉瘤的关键，一经确诊立即行手术治疗，就地手术止血是成功抢救假性动脉瘤破裂的关键。

Purpose:To improve the diagnosis and treatment of the false aneurysm in the allo-grafted renal artery. Methods: 2 cases of the allografted renal artery false aneurysm were studied bymeans of retrospective analysis in 771 cases of recipients of allografted kidney. The cause, diagno-sis and treatment of false aneurysm were discussed with literature.Results: 2 false aneurysm oc-curred in the anastomotic parts between allografted renal artery and external iliac artery of recipi-ents 1～2 months after operation. The diagnosis was made according to color Doppler B ultraoundand X-ray photography. One case of false aneurysm rupture occurred 24 hours after allografted re-nal artery and common iliac artery arteriography, the emergent bedside operation was done suc-cessfully. The other case of allografted kidney was rescued by oPeration. Conclusions:The causesof false aneurysm were multifactors. It is the key to prevent the false aneurysm that resisting re-jection reaction, preventing infection and improving the skill of surgeon. It is necessary to Performthe operation for the treatment of false aneurysm. It is the key to rescue the patient life that the e-mergent bedside operation for hemostasis in false aneurysm rupture.