论文部分内容阅读
连续969例尸体肾移植中,有33例术后发生输尿管并发症(3.3%).其中尿漏与输尿管梗阻分别为21例和12例。有11例膀胱输尿管吻合口漏与5例输尿管梗阻在术后早期发生,均与手术操作不当有关,早期手术探查解除诱因后均获治愈。10例因输尿管坏死导致输尿管缺损尿漏,其中3例在术后2.5~4个月发生输尿管坏死,可能与输尿管排异有关。根据输尿管残留长度分别采用不同的手术方法,替代和弥补输尿管短缺。8例获得治愈,术后发生尿漏2例,移植肾失功肾切除1例。另有7例输尿管梗阻患者均采用手术治疗,治疗效果满意。作者对肾移植后输尿管并发症的发生率、预防措施、与排异的关系、诊断和处理进行了讨论。
Of the 969 consecutive cadaveric kidney transplants, 33 developed postoperative ureteral complications (3.3%). Urine leakage and ureteral obstruction were 21 cases and 12 cases respectively. There were 11 cases of vesicoureteral anastomotic leakage and 5 cases of ureteral obstruction in the early postoperative period, which were all related to the improper operation. All the patients were cured after early surgical exploration. 10 cases of ureteral injury caused by ureteral leakage of urine leakage, of which 3 cases 2.5 to 4 months after the occurrence of ureteral necrosis, ureteral rejection may be related. According to the length of ureteral residual surgery were used to replace and make up for a shortage of ureters. 8 cases were cured, 2 cases of postoperative urine leakage occurred, kidney transplantation in 1 case of renal failure. Another 7 cases of ureteral obstruction patients were treated by surgery, the treatment effect is satisfactory. The authors discuss the incidence of ureteral complications after kidney transplantation, precautions, relationship with exclusion, diagnosis and treatment.