肾移植术后围手术期出血的诊断与治疗

Diagnosis and treatment of Perioperative bleeding in kidney transplantation

目的探讨。肾移植术后围手术期出血的原因、诊断与治疗。方法回顾性的分析23例肾移植患者的临床资料。根据出血原因分为①移植肾破裂；②移植肾动脉出血；③移植肾静脉出血；④其他原因出血。分析了引起出血的因素、诊断、治疗和预防措施。结果本组出血患者23例，均进行了手术。1例移植肾破裂、1例肾动脉破裂因无法修补而切除移植肾；2例移植肾破裂术后死亡；2例髂外静脉窦破裂，修补术中移植肾二次再灌注，术后移植肾功能延迟恢复；其余患者移植肾功能均正常恢复。结论肾移植术后围手术期出血的患者，应及时手术，并对不同原因的出血采用不同的手术方式。

Objective To investigate the causes, diagnosis and treatment of perioperative bleeding in kidney transplantation. Methods The clinical materials of 23 cases patients in kidney transplantation were analyzed retrospectively. The causes of bleeding were classified as follows ： （1）rupture of allograft ; （2）allograft artery hemorrhage; （3）kidney vein bleeding; （4）other causes of bleeding. Causes, diagnosis, treatment and precautions were analyzed. Results 23 cases patients of bleeding in this group are all treated with operation. One case of al- lograft rupture and one case of artery rupture were carried out with allograft resection because of serious damage; two cases of vein sinus rupture were carried out with repair and second perfusion. DGF（ delayed graft function） were occurred in this two patients; others patients recovered with normal allograft function. Conclusion The patients of perioperative bleeding in kidney＇transplantation should be carried Out with different operations in time according to the different causes of hemorrhage