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目的:总结移植肾血栓形成的病因、临床表现、诊断、治疗及预后。方法:回顾分析移植肾动脉血栓形成2例,静脉血栓形成1例的临床资料。结果:1例行移植肾切除术;1例肾动脉取栓术后因未能挽救移植肾功能而最终切除;1例移植肾切除后,即刻在同侧行第2次肾移植术,并取得成功。结论:外科技术失误为其最主要的原因,另外还与高龄、幼儿、女性供体,动脉粥样硬化或狭窄,缺血时间过长等有关。动脉血栓形成主要表现为突发的无尿,静脉血栓表现为少尿伴移植肾区胀痛甚至移植肾破裂。移植肾血栓多发生在移植后2d内,是早期移植肾丧失功能的重要原因。治疗手段有抗凝溶栓治疗、手术取栓及移植肾切除术。对该病预防重于治疗。
Objective: To summarize the etiology, clinical manifestation, diagnosis, treatment and prognosis of transplanted renal thrombosis. Methods: The clinical data of 2 cases of renal transplant thrombosis and 1 case of venous thrombosis were retrospectively analyzed. Results: One case underwent nephrectomy. One case underwent renal artery thrombectomy, which failed to save the function of renal allograft and finally removed. One case underwent nephrectomy and received the second renal transplantation immediately success. CONCLUSIONS: Surgery technical errors are the most important cause. In addition, it is also related to elderly, young children, female donors, atherosclerosis or stenosis, and prolonged ischemia. Arterial thrombosis is mainly manifested as sudden anuria, venous thrombosis showed oliguria with transplanted kidney area pain and even renal allograft rupture. Transplantation of renal thrombosis occurred in 2d after transplantation, is an important reason for the loss of early graft function. Treatment of anticoagulant thrombolytic therapy, surgical thrombectomy and nephrectomy. Prevention of the disease is more important than treatment.