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目的探讨肾移植相关血管并发症的处理方式。方法回顾性分析山东大学附属千佛山医院8例肾移植术后血管并发症患者的临床资料,并对其治疗方法进行总结。结果 8例肾移植术后血管并发症患者中,5例出现移植肾动脉狭窄,1例出现肾动脉假性动脉瘤,1例发生移植肾静脉血栓形成,1例在术中发现髂内动脉管腔狭窄且有硬化斑块形成,且均经彩色多普勒超声及动脉血管造影确诊或术中证实。随访发现,2例肾动脉狭窄单纯球囊扩张患者中,1例出现再狭窄后行支架置入术,另1例单纯球囊扩张患者及3例肾动脉狭窄支架置入患者未出现再狭窄;1例肾动脉假性动脉瘤覆膜支架置入术后患者及1例髂内动脉内膜剥脱术后再吻合的肾移植患者,肾动脉均保持血流通畅;1例肾静脉血栓形成患者,经多次彩色多普勒超声复查显示,移植肾静脉血流恢复通畅,未再形成血栓。8例患者症状均明显改善且肾功能恢复良好。结论血管外科技术(尤其腔内治疗技术)在预防和处理肾移植相关血管并发症中,发挥了重要的作用。
Objective To investigate the treatment of vascular complications related to renal transplantation. Methods The clinical data of 8 patients with vascular complications after renal transplantation were analyzed retrospectively in Qianfoshan Hospital Affiliated to Shandong University. The treatment methods were summarized. Results Among the 8 cases of post-renal vascular complications, renal artery stenosis occurred in 5 cases, renal artery pseudoaneurysm in 1 case, graft vein thrombosis in 1 case, internal iliac artery in 1 case Stenosis and plaque formation, and were confirmed by color Doppler ultrasound and arterial angiography or intraoperative confirmation. Follow-up found that in 2 patients with simple balloon dilatation of renal artery stenosis, one case had restenosis followed by stenting, and the other one patient with simple balloon dilatation and 3 cases with renal artery stenosis stent did not appear restenosis. 1 case of renal artery pseudoaneurysm covered stents patients and 1 case of internal iliac artery intimal restenosis re-matched renal transplant patients, renal artery were to maintain blood flow; 1 case of renal vein thrombosis, After repeated color Doppler ultrasound examination showed that graft renal vein blood flow recovered, no further thrombosis. The symptoms of 8 patients were significantly improved and renal function recovered well. Conclusion Vascular surgery (especially endovascular treatment) plays an important role in the prevention and treatment of vascular complications associated with renal transplantation.