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目的:探讨移植肾切除的原因和手术安全性。方法:回顾分析复旦大学附属中山医院25年来626例肾移植患者中46例移植肾切除的原因和并发症。结果:切除的46例移植肾中急性排斥反应20例(45.20%),慢性排斥反应16例(34.78%),加速排异2例,动脉栓塞1例,感染4例,肾破裂2例和肾动脉破裂1例。感染和出血为术后最多见的并发症,共9例(19.56%),死亡2例(4.34%)。环孢素A(CsA)使用后移植肾切除率7.72%,与CsA使用前的27.78%相比移植肾切除率明显减少(P<0.01)。结论:移植肾切除的主要原因是急慢、性排斥反应。CsA的使用是移植肾切除减少的原因之一。移植肾切除手术风险大,并发症多,手术前后合理的处理可增加手术安全性。
Objective: To investigate the causes and surgical safety of transplanted nephrectomy. Methods: Retrospective analysis of the causes and complications of 46 cases of renal allograft in 626 renal transplant patients admitted to Zhongshan Hospital Affiliated to Fudan University in 25 years. Results: There were 20 cases (45.20%) of acute rejection, 46 cases of chronic rejection (34.78%), 2 cases of accelerated rejection, 1 case of arterial embolism, 4 cases of infection, 2 cases of renal rupture, Artery rupture in 1 case. Infection and hemorrhage were the most common complication after operation, with 9 cases (19.56%) and 2 deaths (4.34%). Cyclosporine A (CsA) after the use of grafting nephrectomy rate of 7.72%, compared with 27.78% before CsA use, the nephrectomy rate was significantly reduced (P <0.01). Conclusion: The main reason of renal allograft is acute and slow rejection. The use of CsA is one of the reasons for the reduced nephrectomy. Kidney nephrectomy risk, complications, and reasonable treatment before and after surgery can increase the safety of surgery.