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目的探讨移植肾动脉狭窄的诊治方法。方法回顾性分析253例肾移植术后发生的3例移植肾动脉狭窄(transplantrenalarterystenosis, TRAS)的诊治经过。结果3例TRAS均发生于肾移植术后半年内,经彩超和肾动脉造影确诊。3例均行经皮穿刺移植肾动脉球囊扩张成形(percutaneoustransluminalrenalangioplasty, PTRA)和血管内支架置入,获临床治愈。随访15~24个月,无TRAS复发,移植肾功能正常。结论彩超是筛选TRAS的首选检查方法,肾动脉造影是TRAS的确诊手段。PTRA/血管内支架置入是治疗TRAS的安全、有效和首选方法。
Objective To investigate the diagnosis and treatment of renal artery stenosis. Methods The diagnosis and treatment of 3 cases of transplant renal artery stenosis (TRAS) after renal transplantation were retrospectively analyzed. Results All three cases of TRAS occurred within six months after renal transplantation, confirmed by color Doppler ultrasound and renal artery angiography. Three patients underwent percutaneous transplanting of renal artery balloon dilatation (PTRA) and endovascular stenting, and were clinically cured. Followed up for 15 to 24 months, no TRAS recurrence, normal renal graft function. Conclusion Color Doppler ultrasonography is the first choice of screening for TRAS. Renal artery angiography is the diagnostic tool of TRAS. PTRA / endovascular stent placement is a safe, effective and preferred method of treatment for TRAS.