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目的探讨肾移植术后感染性髂外动脉吻合口出血的处理。方法报告1例髂内动脉自体移植治疗感染性髂外动脉吻合口大出血病例,结合文献复习讨论。患者,男,25岁。肾移植术后第22、24、38天3次出现感染性移植肾动脉髂外动脉吻合口大出血,出血量分别达800、2500、3800ml。经输血、及时手术探查,两次吻合口缝合修补效果不佳,第3次手术切除移植肾,并将感染病变严重的髂外动脉段切除,髂外动脉缺损长约2cm,以3cm长的髂内动脉段移植修复。结果修复后髂外动脉血流通畅,患侧下肢血供良好,患者恢复血液透析,等待再次移植。结论感染性移植肾动脉髂外动脉吻合口出血为肾移植术后严重并发症,单纯修补常难以奏效,髂内动脉自体移植修补缺损合理可行,操作简易,效果较好。
Objective To investigate the treatment of infectious iliac artery anastomotic bleeding after renal transplantation. Methods One case of iliac artery autotransplantation for the treatment of infectious iliac artery anastomotic bleeding cases, combined with the literature review and discussion. Patient, male, 25 years old. Three days after the renal transplantation, infectious hemorrhage occurred in the anastomotic external iliac artery of rabbits on the 22nd, 24th, and 38th days. The hemorrhage reached 800, 2500 and 3800ml respectively. The blood transfusion, timely surgical exploration, two anastomotic suture repair ineffective, the third surgical resection of the kidney graft, and the infection of severe external iliac artery segment removal, external iliac artery defect about 2cm, with 3cm long iliac Internal arterial graft repair. Results After the repair of external iliac artery blood flow, ipsilateral lower limb blood supply is good, the patient hemodialysis, waiting for a second transplant. Conclusions Infectious transplantation renal artery anastomosis of external iliac artery hemorrhage is a serious complication after renal transplantation. It is often difficult to repair simply by repairing the defect. Autologous transplantation of internal iliac artery is reasonable and feasible to repair the defect. The operation is simple and the effect is good.