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目的:提高肾移植术后移植肾动脉破裂的诊治水平。方法:回顾性分析临床所见4例肾移植术后移植肾动脉破裂诊治并复习国内外病例文献资料。结果:移植肾动脉破裂口均不在吻合口,离吻合口距离为0.5~0.8cm;破裂原因:3例为霉菌感染,1例为细菌感染;经行移植肾切除和抗真菌、抗菌治疗后,2例受者恢复血透,1例因术中肺梗塞死亡,1例因失血性休克而死亡。结论:移植肾动脉破裂临床上较少见,后果严重,不仅会影响到移植肾功能,更可能危及病人生命,早期诊断、紧急手术探查和特异性治疗可改善预后,挽救患者生命。
Objective: To improve diagnosis and treatment of renal artery rupture after renal transplantation. Methods: Four cases of renal artery rupture after renal transplantation were retrospectively analyzed and reviewed in literatures at home and abroad. Results: All the ruptured renal artery grafts were not at the anastomotic site, the distance from the anastomosis was 0.5 ~ 0.8cm. The causes of rupture were: 3 cases of fungal infection and 1 case of bacterial infection. After transplantation and antifungal therapy, Two patients recovered hemodialysis, one died of intraoperative pulmonary infarction and one died of hemorrhagic shock. CONCLUSIONS: Renal artery rupture is clinically rare with serious consequences. It may not only affect renal function but also endanger the life of patients. Early diagnosis, emergency surgical exploration and specific treatment may improve prognosis and save patient’s life.