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患者男,46岁。3年前曾行“同种异体肾移植术”,因移植肾动脉血栓形成,手术后20天将移植肾切除。此次入院拟行第二次同种异体肾移植,入院时查体一般情况尚可,面部轻度浮肿,余无特殊。术前实验室检查:BUN36.76mmol/L,血Cr 1072μmol/L。入院第3天行手术,手术顺利。术后第3天患者开始出现发热、少尿、肾区痛,临床考虑“超急性排异反应”。术后第4天行移植肾SPECT显像。检查方法:病人仰卧,检查视野包括移植肾及膀胱区,肘静脉“弹丸”式注射~(99m)Tc-EC37mBq,立即动态采集共28分钟。结果示:(1)肾动脉血供大致正常;(2)肾小管摄取功能较差,排泄极缓,肾图呈梗阻型
Male patient, 46 years old. 3 years ago had “allograft kidney transplantation”, due to graft renal artery thrombosis, 20 days after the operation will be transplanted nephrectomy. The hospital admission to be the second allograft kidney transplantation, general physical examination admitted to hospital, mild facial edema, I no special. Preoperative laboratory tests: BUN36.76mmol / L, blood Cr1072μmol / L. Admission the first 3 days of surgery, surgery went well. On the third postoperative day, the patient started to have fever, oliguria, and kidney area pain, and the clinical consideration was “hyperacute rejection.” On the 4th postoperative day, SPECT imaging was performed. Inspection method: The patient was supine. The examination field of vision included the area of the kidney and bladder and the ~99m Tc-EC37mBq injected into the elbow vein. Dynamic acquisition was performed immediately for 28 minutes. The results showed: (1) renal artery blood supply is generally normal; (2) tubular uptake function is poor, excretion extremely slow, renal obstruction