肾移植术后并发下消化道出血临床诊疗(附15例报告)

Clinical diagnosis and treatment of lower digestive tract hemorrhage after renal transplantation(a report of 15 cases)

目的探讨肾移植术后并发下消化道出血的诊断与治疗。方法回顾性分析我院2005年1月～2012年12月间共计15例肾移植术后并发下消化道出血病例资料。结果 12例患者通过内科保守治愈;3例因广泛肠道面粘膜糜烂、反复大出血,经肠系膜动脉造影、栓塞得到成功救治。结论肾移植术后患者并发下消化道出血在临床较为少见,通常经积极保守治疗可取得良好预后。但在内科治疗无效的情况下,首选肠镜、肠系膜动脉造影检查明确出血病灶,并进一步治疗。

Objective To investigate the diagnosis and treatment of lower digestive tract hemorrhage after renal transplantation. Methods Retrospective analysis was made in the data of 15 cases of lower digestive tract hemorrhage after renal transplantation between January 2005 and December 2012. Results Twelve patients were cured by conservative treatment of internal medicine. Recurrent hemorrhea caused by extensive intestinal mucosal erosion occurred in 3 cases which were successfully rescued through mesenteric arteriography and embolization. Conclusion Lower digestive tract hemorrhage after renal transplantation renal is rare in clinic. Usually the positive conservative treatment can achieve good prognosis. But if the treatment of internal medicine fail, enteroscope and mesenteric arteriography should be used as the first choice to clearly find out the bleed focus and carry out the further treatment.