介入治疗肾移植术后并发症临床研究

Interventional treatment of the complications occurring after renal transplantation: a clinical study

目的评估多模式介入治疗肾移植术后并发症的安全性及有效性。方法回顾26例肾移植术后并发症患者临床资料,观察分析采用不同介入技术治疗血管性和非血管性并发症的效果。结果血管性并发症19例,非血管性并发症7例。所有患者介入治疗技术成功率为100%。术后1周总肌酐水平(184.3±138.4)μmol/L较术前(372.7±295.5)μmol/L明显改善(P<0.001),无严重并发症发生。进一步分析发现血管治疗组与非血管治疗组患者一般情况、供肾来源、吻合方式差异无统计学意义(P>0.05),并发症发病时间(1.8±1.4)个月对(118.3±54.4)个月差异有显著统计学意义(P<0.001)。随访4~55个月(平均18.6个月)中3例复发,2例再次介入治疗后肌酐水平恢复正常,1例伴假性动脉瘤患者接受移植肾动脉栓塞术。结论介入治疗肾移植术后并发症具有创伤小、恢复快、安全可行等优点,可及时有效地改善肾功能,挽救移植肾。

Objective To evaluate the safety and effectiveness of multi-mode intelventional therapy for complications occurring after renal transplantation. Methods The clinical data of 26 patients with complications occurring after renal transplantation were retrospectively analyzed. Vascular and non-vascular complications were treated with different interventional techniques, and the curative effects were analyzed. Results Vascular complications were observed in 19 patients and non-vascular complications were seen in 7 patients. The technical success rate of interventional therapy was 100%. One week after the treatment, the total ereatinine level （SCr） was significantly improved, which decreased from preoperative （372.7±295.5）μmol/L to postoperative （184.3±138.4） μmol/L （P〈0.001）. No severe complications occurred. Further analysis indicated that no statistically significant differences in patient＇s general condition, kidney donor source, anastomosis method existed between vascular intervention group and non-vascular intervention （P〉0.05）. However, the onset time of vascular complications was markedly earlier than that of non-vascular complications （1.8±1.4 months vs. 118.3±54.4 months）, the difference was statistically significant （P〈0.001）. During the follow-up period lasting for 4-55 months （mean of 18.6 months）, 3 patients developed recurrence of complications; interventional therapy had to be carried out in 2 patients and their creatinine level returned to normal after treatment, and transplanted renal artery embolization had to be performed in the other patient as whose pseudoaneurysm became enlarged. Conclusion For the treatment of complications occurring after renal transplantation, interventional therapy is less-invasive, rapidly-effective and safe, this technique can timely and effectively improve the renal function and save the transplanted kidney.