移植肾功能异常的外科因素及处理分析

Surgical factors of renal allograft dysfunction and its＇ treatment

目的 探讨移植肾功能异常的外科因素及其处理.方法 回顾性分析因为外科因素导致血肌酐升高的8例肾移植患者的临床资料并复习文献.结果 8例患者中,输尿管末段狭窄5例（62.5％）,输尿管结石、假性动脉瘤、前列腺增生症各1例（12.5％）.8例患者相应的外科处理均顺利完成,术后24～115 d（平均46.3 d）血肌酐由之前的115.0 ～395.1μmol/L（平均249.8 μmol/L）下降到56～252μmol/L（平均123.1 μmol/L）.结论 外科因素中以输尿管狭窄为主,其次是输尿管结石、假性动脉瘤、前列腺增生症.重视并积极处理外科因素,肾功能往往能获得良好恢复.

Objectives To investigate the surgical factors and treatment of renal allograft dysfunction.Methods The clinical data of 8 patients with elevated serum creatinine because of surgical factors were analysized retrospectively,and the literatures were reviewed.Results Of 8 cases,five cases with ureteral stenosis（62.5％）,one case with ureteral calculi（12.5％）,one case with false aneurysm（12.5％） and one case with benign prostatic hyperplasia（12.5％）.Eight patients were treated successfully.24 ～ 115 d （average 46.3 days） after operation,serum creatinine decreased to 56 ～ 252 μmo/L （average 123.1 μmo/L） from the previous 115 ～ 395.1 μmo/L （average 249.8 μmo/L）.Conclusions The main surgical factor of renal allograft dysfunction was ureteral stricture,other factors included ureteral calculi,false aneurysm and benign prostatic hyperplasia.Those surgical factors should be pay more attention and treated actively,then the renal function could get a good recovery.