摘要
目的:通过观察围手术期及术后3个月肾移植患者肾形态结构和相关血流的彩色多普勒超声指标变化,分析彩色多普勒超声对肾移植术后并发症的早期评估作用。方法:选择2005-04/2006-04在南方医院超声诊断科就诊的同种异体肾移植患者152例,患者均知情同意。应用彩色多普勒超声对肾移植患者进行术前评价和术后监测,重点观察肾移植术后3d、术后7d、术后1个月及术后3个月内移植肾形态结构及血流动力学各项参数,及时发现术后并发症。先用二维超声观察移植肾的形态,测量长径、宽径、厚径,并测量肾皮质厚度和锥体大小。随后应用彩色多普勒血流显像观察移植肾髂动脉、吻合口处肾动脉、肾门处肾动脉、段动脉的血流充盈情况,接着用高频探头检测大叶间动脉和小叶间动脉的血管树结构。最后用脉冲式多普勒采集频谱,测量收缩期峰值血流速度、舒张末期血流速度、阻力指数和搏动指数等。结果:152例肾移植患者全部进入结果分析,无脱落。术后彩色多普勒超声及时发现手术并发症64例,占肾移植患者的42.11%,部分受检者同时合并两项或多项并发症。①急性排斥反应23例,发病率15.14%,移植肾各级动脉阻力指数均大于0.75,其中大于0.85的患者共12例。②吻合口处肾动脉狭窄14例,发病率9.22%,收缩期峰值流速明显增高,均收缩期峰值流速>180cm/s,其中收缩期峰值流速>300cm/s的患者5例,占35.71%,14例病例中合并急性排斥者6例,占42.86%。③肾盂积水25例,发病率16.45%,移植肾大小为(208.52±42.43)cm3;肾周积液20例,发病率13.16%。结论:应用彩色多普勒超声动态观察肾移植术前、术后肾内血流灌注情况,以各项血流指标进行临床评估,有助于及早发现术后并发症,对于提高肾移植术的成功率和患者的生存率具有重要意义。
AIM： To assess the applied value of color Doppler ultrasound in continued monitoring the postoperative complications of renal transplantation by observing the renal morphous and related hemodynamic index of patients fore-and-aft three months of renal transplantation. METHODS： The experiment was carried out among 152 patients underwent allograft renal transplantation in Ultrasound Department of Nanfang Hospital from April 2005 to April 2006. With the informed consents, all the patients received pre-operative evaluation and postoperative monitor, emphasizing on the renal morphous, hemodynamic index and complications after renal transplantation in three days, seven days, one month and three months.. First, two-dimensional imaging was used to observe the shape of the transplant kidneys and measure length, width, thickness, cortical thickness and pyramid size of kidney. Secondly, color Doppler ultrasound was ,used to observe the iliac artery of the transplant kidneys and the anastomose of the renal artery as well as segmental artery of kidney. And then, high frequency probe was used to check the interlobar and interlobular artery of kidney. Finally, pulsed Doppler was used to collect spectra and measure the peak systolic velocity （PSV）, end- diastolic velocity, resistance index and pulsate index. RESULTS： All 152 patients were involved in the result analysis without any drop. There were 64 cases presented complications with an incidence of 42.11%. Partly of them were found more than two complications. ①lt included 23 cases with acute rejection, accounting for 15,14%. The resistance index of each renal artery was all more than 0.75, thereinto, 12 cases more than 0.85. ②There were 14 cases renal artery stenosis, taking up to 9.22% All of the PSV were more than 180 cm/s, thereinto, there were 5 cases （35.71%） more than 300 cm/s, 6 cases （42.86%） intercurrent acute rejection.③There were 25 cases hydronephrosis, with the incidence of 16.45%, The size of the transplant kidney was （208.52±42.43）
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第4期601-604,I0001,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
