肾移植的血管外科问题探讨(附3例肾移植报告)

VASCULAR SURGICAL PRINCIPLES IN RENAL ALLOTRANSPLANTATION(3CASES REPORT)

目的 :提高肾移植中有关血管的外科合理处理能力。方法 :结合 3例临床肾移植病例和阅读文献 ,总结肾移植中有关血管外科问题与处理方法。结果 :术前应熟练掌握肾血管的解剖和血管变异情况 ;移植受体可直接或用人造血管建立动静脉瘘以便术前充分透析 ;术中合理处理受体髂动脉硬化斑块和髂静脉瓣膜 ;以及掌握良好的血管吻合技术 ;术后彩超检查监护移植肾血管吻合通畅情况。结论 :同种肾移植中应熟练掌握肾血管的解剖 ,血管变异情况 ,肾血管的病理和血管外科技术。

Objective: To improve the ability of management on vascular surgical principles in renal allotransplantation. Methods : The vascular surgical principles in renal allotransplantation were reviewed and summed up on the basis of 3 cases of clinical renal allotransplantation and a series of references .Results: The kidney anatomy and its anatomical variations must understood sufficently;fistula may be done in recipient between peripheral artery and vein by direct or artificial vascular graft ePTF anastomosis in order to get more complete hemodialysis before operation ; management of sclerosis oblique in iliac artery and valve in iliac vein and, vascular anastomosis skills were also important . Colour-code Doppler ultrasonography was the best choice to know the renal artery and vein blood flow after operation.Conclusion:The kidney anatomy and it's anatomical varieties must be skilled , vascular anastomosis skills were also important .