肾移植后下肢深静脉血栓2例

Deep venous thrombosis in the lower extremities following renal transplantation in two patients

背景:肾移植患者存在引发下肢深静脉血栓的诸多危险因素,如何有效降低该并发症的发生,并对其做出及时诊断、正确处理,对临床有重要的指导意义。目的:探讨肾移植患者下肢深静脉血栓的诊断、治疗及预防。方法:回顾性分析2例肾移植后发生下肢深静脉血栓患者的诊断依据及治疗效果,并对相关文献进行复习。结果与结论:依据病史、超声确诊的两例患者经及时的治疗(包括抗凝、溶栓等),均在六七天内患肢肿胀基本消退,彩超检查下肢深静脉血流通畅,患者完全康复,肾功能正常。提示,肾移植患者有引发下肢深静脉血栓的较多危险因素,彩色多普勒超声是最佳诊断措施,规范及时的抗凝、溶栓治疗可取得满意效果。对肾移植术后高危患者应采取一定的预防措施。

BACKGROUND：Renal transplantation recipients are exposed to greater risks of developing deep venous thrombosis in the lower extremities （LDVT）.How to effectively reduce this complication following renal transplantation and prompt diagnosis and correct treatment has an important significance. OBJECTIVE：To investigate the diagnosis, treatment and prevention of LDVT following renal transplantation. METHODS： To retrospectively analyze the diagnosis and treatment of two renal transplantation recipients who developed LDVT and to review the relative literatures. RESULTS AND CONCLUSION：The two patients were diagnosed by color Doppler ultrasound examination and systemic medical history review. After timely and effective treatments including anticoagulation and thrombolysis, the two cases recovered at 6 and 7 days after treatment, showing evidence of establishment of efficient collateral circulation, as found in color Doppler ultrasound examination, and renal function was normal. The results demonstrated that renal transplantation recipients are exposed to greater risks of developing LDVT, for which color Doppler ultrasound provides the most effective diagnosis.The patients generally respond well to timely interventions with anticoagulation, clot removal and thrombolysis, and preventive measures are indicated in those at high risk of LDVT following transplantation.