肾移植术后移植肾积水的治疗方法探讨临床医学.docVIP

肾移植术后移植肾积水的治疗方法探讨临床医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：肾移植术后移植肾积水的治疗方法探讨临床医学 1 1 资料与方法 2 2 结果 4 3 讨论 4 文2：两种术式治疗颅脑损伤去骨瓣减压术后脑积水的临床观察 5 1资料与方法 6 参考文摘引言： 8 原创性声明（模板） 10 文章致谢（模板） 10 正文 肾移植术后移植肾积水的治疗方法探讨临床医学 文1：肾移植术后移植肾积水的治疗方法探讨临床医学 【Abstract】 Objective To evaluate the technologies in treatment of hydronephrosis in traplanted kidney because of ureteric obstruction. Methods 17 recipients suffered from hydronephrosis in traplanted kidney and treated in our department from 2002, 12 to 2007,6. The data of 17 cases were studied 3 cases were treated by traurethral retrograde ureteroscope dilation repeated 2～3 cases were treated by Boari flap technique and 2 cases were treated by ureter reimplantation. Of the 7 cases 2 developed urinary fistula ,2 got wound infection and 1 experienced allograft renal traplanted kidneies were function lost because of chronic allograft nephropathy. Another 7 cases were treated by ureteroureterostomy or pyeloureterostomy using native distal ureter via cavity. This 7 cases recoverd completely without any surgical complication. 1 traplanted kidney was chronic allograft renal disfunction. Conclusion Try to use minimally invasive technology should be undertake in the treatment of hydronephrosis in traplanted kidney. Ureteroureterostomy or pyeloureterostomy using native distal urter were relatively effective and safe .It is advisable for the treatment of ureteric obstruction after kidney traplantation. 【Key words】 ureteral obstruction; hydronephrosis; surgical procedures; kidney traplantation 肾移植术后肾积水是肾移植术后常见外科并发症，也是移植肾慢性失功，影响移植肾有功能存活率的一个主要原因。恰当地选择治疗方案对预后有直接关系。自2002年12月以后，笔者收治了肾移植术后肾积水17例，以自体输尿管与积水的肾移植肾盂或输尿管再吻合，治疗效果好，现报道如下。 1 资料与方法 一般资料 移植肾输尿管积水患者17例，男11例，女6例；年龄11～61岁，平均45岁。发生在术后6个月～3年。17例患者，1例有再次手术探查及肾周积液史，术后肾周积液3个月自行消失，1例肾周积液4cm×6cm×5cm，术后3周经B超定位下穿刺抽液治疗。17例中有5例术中精索或子宫韧带未切断。就诊时，Scr均超过300μmol/L。最高者达860μmol/L。肾盂输尿管积水的原因诊断：吻合口狭窄10例，精索压迫1例，输尿管远端与周围组织粘连6例。其中1例以畏寒、发热、尿少入院，诊断为输尿管急性梗阻合并感染，移植肾积水。急诊手术证实为“吻合口狭窄梗阻 泥沙样结石，移植肾积脓