实用器官移植电子杂志

实用器官移植电子杂志 ›› 2019, Vol. 7 ›› Issue (6): 469-471.DOI: 10.3969/j.issn.2095-5332.2019.06.015

• 论著 • 上一篇    下一篇

移植肾功能不全受体肾动脉狭窄的临床分析

廖贵益，唐亮，朱道方，钟金彪，丁汉东，兰天池，杨巧兰   

  1. 安徽医科大学第一附属医院泌尿外科肾脏移植病区，安徽 合肥 230022
  • 出版日期:2019-11-20 发布日期:2021-06-22
  • 基金资助:
    安徽省重点研究与开发计划项目（1704a0802173）

The clinical analysis of renal arterial stenosis of recipients with renal allograft dysfunction

Liao Guiyi，Tang Liang，Zhu Daofang，Zhong Jinbiao，Ding Handong，Lan Tianchi，Yang Qiaolan. 
  

  1. The First AffiliatedHospital of Anhui Medical University，HeFei 230022，Anhui，China
  • Online:2019-11-20 Published:2021-06-22

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摘要：

目的 分析移植肾功能不全受体肾动脉狭窄的发生率、处理方法及处理后的临床效果。方法 回顾性分析 2018 年 11 月—2019 年 3 月本院 52 例移植肾功能不全受体的临床资料，主要包括旋转数字减影血管造血（digital subtraction angiography，DSA）检查结果、肾动脉狭窄受体的介入治疗及临床效果。结果 52 例中 24 例（46.1%）存在明显肾动脉狭窄，狭窄程度为 28% ～ 95%，平均为 66.96%。肾动脉狭窄的表现形式 ：① 肾动脉与髂内动脉吻合口狭窄 ；② 肾主动脉或段动脉折曲 ；③ 肾主动脉节段性狭窄 ；④ 髂内动脉血栓。24 例肾动脉狭窄受体中，21 例接受介入治疗，1 例并发血栓形成至切除移植肾，2 例拒绝介入治疗。 接受介入治疗的 21 例中 17 例（73.9%）1 ～ 3 周内观察到血肌酐值稳定下降，平均血肌酐值由介入治疗前的 269.6 μmol/L 下降到 190.1 μmol/L，下降 29.5%。结论 对于移植肾功能不全的受体，移植肾动脉狭窄是很常见的并发症，要得到重视并常规接受筛查。介入治疗为其首选的处理方法，早发现、早处理能获得一定的临床效果。

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Abstract:

Objective To analyze the incidence rate，treatment and the clinical effect of renal artery stenosisin patients with renal allograft dysfunction. Methods The clinical data of 52 patients with renal allograft dysfunctionin our hospital from November 2018 to March 2019 were reviewed retrospectively. The study mainly includedrotational intra-arterial digital subtraction angiography（DSA），interventional treatment of renal artery stenosis and the clinical effects. Results A total number of 24 of 52 cases（46.1%）encountered obvious renal artery stenosis and the degrees of stenosis were from 28% ～ 95% with an average of 66.96%. The stenosis included：① Anastomotic stenosis ；② Flex of renal artery ；③ Segmental stenosis of renal artery ；④ Thrombosis of Internal iliac artery. 21 of 24 cases received interventional therapy，1 case was received the resection of the transplanted kidney because of thrombosis，2 cases refused any therapy. 17 of 21 cases（73.9%）showed a stable decrease in serum creatinine valuewithin 1 to 3 weeks，and the mean blood creatinine value decreased from 269.6 μmol/L before interventional therapy to 190.1 μmol/L，with a decrease of 29.5%. Conclusion Arterial stenosis is a common complication in recipientswith renal allograft dysfunction and should be emphasized and screened routinely. Interventional therapy is thepreferred treatment method for arterial stenosis，early detection and treatment could achieve certain clinical effects. 

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