中国组织工程研究

中国组织工程研究

• 肾移植 kidney transplantation • 上一篇    下一篇

肾移植后移植肾功能的延迟恢复★

孙  楠，刘  乾，石理华，李  瑛，李  辉   

  1. 武警后勤学院附属医院肾病科，天津市  300162
  • 收稿日期:2011-12-05 修回日期:2012-01-13 出版日期:2012-04-29 发布日期:2012-04-29
  • 通讯作者: 李辉，博士，主任医师，武警后勤学院附属医院肾病科，天津市 300162 jstzzl2000@yahoo.com.cn
  • 作者简介:孙楠★，女，1982年生，天津市人，汉族，2009年河北医科大学毕业，硕士，主要从事肾脏病临床及血液透析研究。jstzzl2000@ yahoo.com.cn

Delayed graft function after kidney transplantation

Sun Nan, Liu Qian, Shi Li-hua, Li Ying, Li Hui   

  1. Department of Nephropathy, Affiliated Hospital of Logistics University of Chinese People’s Armed Police Forces, Tianjin  300162, China
  • Received:2011-12-05 Revised:2012-01-13 Online:2012-04-29 Published:2012-04-29
  • Contact: Li Hui, Doctor, Chief physician, Department of Nephropathy, Affiliated Hospital of Logistics University of Chinese People’s Armed Police Forces, Tianjin 300162, China jstzzl2000@yahoo. com.cn
  • About author:Sun Nan★, Master, Department of Nephropathy, Affiliated Hospital of Logistics University of Chinese People’s Armed Police Forces, Tianjin 300162, China jstzzl2000@yahoo.com.cn

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摘要：

背景：移植肾功能延迟恢复是肾移植常见的并发症，充分探究其发生的危险因素，及时预防与对应综合治疗是肾移植成功的关键。
目的：探讨肾移植后移植肾功能延迟恢复发生的病因及治疗方法。
方法：回顾性分析2000-12/2011-01在武警后勤学院肾移植中心明确诊断为肾移植后肾功能延迟恢复108例患者的临床资料，均为尸肾移植，给予相应治疗，观察临床疗效并综合分析出现肾功能延迟恢复的原因。
结果与结论：发生肾移植后移植肾功能延迟恢复的病因包括急性排斥反应52例(48.2%)，急性肾小管坏死45例(41.5%)；动脉吻合口狭窄5例(4.6%)，输尿管梗阻3例(2.8%)，环孢素A中毒肾病6例(5.6%)。89例患者经治疗后移植肾功能恢复正常，12例血肌酐稳定在200 μmol/L左右，2例因应用抗淋巴细胞球蛋白后并发肺部感染死亡，5例应用甲基强的松龙冲击治疗后移植肾功能未好转而恢复血液透析治疗。提示急性排斥反应及急性肾小管坏死是引起肾移植后肾功能延迟恢复的主要因素，应采取综合治疗措施积极纠正。

关键词: 肾功能延迟恢复, 肾移植, 急性排斥反应, 急性肾小管坏死, 治疗

Abstract:

BACKGROUND: Delayed graft function (DGF) is a common complication of kidney transplantation, fully exploration of the risk factors and timely prevent and the corresponding comprehensive treatment is the key to the success of kidney transplantation.
OBJECTIVE: To investigate the cause and treatment of DGF after kidney transplantation.
METHODS: A retrospective analysis was preformed on 108 cases of DGF after kidney transplantation who admitted in Department of Nephropathy, Affiliated Hospital of Logistics University of Chinese People’s Armed Police Forces from December 2000 to January 2011. All the 108 patients received cadaveric kidney transplantation and corresponding treatment. The clinical effects were observed and the comprehensive analysis of the reasons for DGF was analyzed.
RESULTS AND CONCLUSION: In the 108 patients with DGF, the causes were acute rejection episode in 52 cases (48.2%), acute renal tubular necrosis in 45 cases (41.5%), graft artery anastomotic stenosis in 5 cases (4.6%), ureteral obstruction in 3 cases (2.8%) and acute cyclosporine anephrotoxicety in 5 cases (5.6%). The renal function became normal in 89 patients; serum creatinine returned to 200 μmol/L or so in 12 cases; there were 2 cases died of pulmonary infection after using antilymphocyte globulin while 5 cases resumed dialysis with failure to methylprednisolone treatment. Acute rejection and acute renal tubular necrosis are the main reasons for DGF and the combined therapeutic measure should be taken.

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