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目的:探讨移植肾自发性破裂的原因及防治措施。方法:回顾分析本院392例同种肾移植术后发生移植肾自发性破裂20例临床资料。结果:发生率为5.1%。14例保留肾脏成功,其中2例经保守治疗痊愈。6例肾切除者中有4例为急性排斥反应引起。结论:肾破裂的发生与排斥反应、肾缺血性损害、肾静脉引流不畅及尿路梗阻有关。对于出血量少、肾功能好者,可采用保守治疗。预防要从肾脏摘取与灌洗、植肾手术、合理应用免疫抑制剂、及早处理排斥反应等多方面着手。
Objective: To investigate the causes and prevention measures of spontaneous rupture of renal allograft. Methods: The clinical data of 20 cases of spontaneous renal allograft rupture occurred after 392 renal transplantation in our hospital were retrospectively analyzed. Results: The incidence was 5.1%. Of the 14 patients who had retained the kidneys successfully, 2 of them were cured by conservative treatment. In 6 cases of nephrectomy, 4 cases were caused by acute rejection. Conclusion: The incidence of renal rupture is related to rejection, renal ischemic injury, poor renal vein drainage and urinary tract obstruction. For less bleeding, good kidney function, conservative treatment can be used. Prevention from the kidneys to pick and lavage, kidney surgery, rational use of immunosuppressive agents, early treatment of rejection and many other aspects.