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目的探讨总结肾移植术后受者并发自体尿路上皮肿瘤的发生率、临床特征、诊治体会及原因分析。方法回顾性分析了我院2006年1月至2011年7月1 042例肾移植术后接受至少6个月的免疫抑制治疗受者的病历资料。结果在1 042例肾移植受者中,发生尿路上皮肿瘤者为12例,发生率为1.2%,全部病历资料完整,其中9例(75.0%)因血尿就诊,3例(25.0%)因查体发现,包括1例自感尿频,1例因腰痛就医而诊断。所有患者均经手术治疗。生存良好9例,死亡3例。结论对肾移植后并发尿路上皮肿瘤的患者要高度重视,对血尿症状要高度警惕,重视术后检查,密切随访,早期诊断,积极行根治性手术治疗,减少免疫抑制剂的用量。
OBJECTIVE: To investigate the incidence, clinical features, diagnosis and treatment of patients with recurrent urinary tract epithelial neoplasms after kidney transplantation and its causes. Methods Retrospectively analyzed the medical record data of 1 042 immunosuppressed patients receiving renal transplantation after at least 6 months from January 2006 to July 2011 in our hospital. Results Of the 1 042 kidney transplant recipients, 12 were urothelial tumors with a prevalence of 1.2%. All the medical records were complete, 9 (75.0%) were referred for hematuria and 3 (25.0%) were due to Physical examination found that, including 1 case of spontaneous urination, 1 case diagnosed due to low back pain. All patients were surgically treated. Good survival in 9 cases, 3 deaths. Conclusions Patients with urothelial tumors after kidney transplantation should be highly valued, and their symptoms of hematuria should be highly vigilant. Postoperative examination, close follow-up and early diagnosis should be paid attention to. Radical surgery should be actively followed to reduce the dosage of immunosuppressive agents.