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目的总结活体供肾肾移植供受体的有关血管解剖。方法查阅近年有关亲属移植供受体血管解剖的国内外文献,并进行综述。结果供受体血管解剖对病例选择、手术方案制定及远期效果均有重要作用。供体过早分支和副肾动脉的存在常会影响手术侧、手术方式和吻合方式的选择,其损伤出血及静脉出血均是导致腹腔镜手术转开放手术的重要原因。随着腹腔镜供肾切除的增多,术前准确肾静脉评估也越来越得到重视。多层螺旋CT可代替常规影像学检查并能准确评估供肾血管、血管变异、肾病变、集合系统和其他相关解剖信息。结论详细了解供受体的肾血管解剖不仅利于手术成功,还能促进活体供肾肾移植的发展。多层螺旋CT已成为供体术前首选“一站式”影像学检查方法。
Objective To summarize the relevant vascular anatomy of living donor kidney transplantation for recipients. Methods To review the domestic and foreign literatures about the blood vessel anatomy of the recipient relatives transplantation in recent years and summarize. Results Vascular anatomy for recipients has an important role in the selection of cases, the development of surgical plans and the long-term results. Premature donor branch and the presence of the renal artery often affect the surgical side, the choice of surgical approach and anastomosis, the bleeding and venous bleeding are caused by laparoscopic surgery to open surgery an important reason. With the increase of laparoscopic nephrectomy, preoperative accurate assessment of renal vein has also been more and more attention. Multi-slice spiral CT can replace routine imaging and accurately assess renal vascular, vascular variability, nephropathy, collection systems, and other relevant anatomical information. Conclusions A detailed understanding of renal vascular anatomy for recipients not only benefits surgical success but also promotes the development of living donor kidney transplantation. Multi-slice spiral CT has become the first choice for preoperative “one-stop” imaging method.