摘要
对近5年的626例次肾移植资料进行总结分析,22例术后发生上消化道出血,25例术后发生移植肾破裂,8例发生肾周出血。消化道出血原因,5例为应激性溃疡,6例为胃十二指肠溃疡,11例为尿毒症性胃肠粘膜糜烂。诊断时常规做单光子发射型计算机断层(SPECT)出血定位检查,能较好检出多部位及下消化道出血。治疗应采取综合止血措施,手术止血时应严格掌握适应证。移植肾破裂大多数与移植肾水肿有关。移植肾周出血的表现一般与肾破裂相似,应与肾破裂相鉴别。治疗大多需急诊手术。移植肾包膜切开减张可显著减少肾破裂率(P<0.01)。侧腹膜及后腹膜腔常为积血区,在诊断及治疗时应予以重视。
Studies were conducted on the inhospital observation and management of renal graft recipients complicated with heavy gastrointestinal haemorrhage(22),graft rupture(25)and perigraft bleeding(8)in 626 cases performed in recent 5 years.The cause of gastrointestinal haemorrhage were stress ulcer(5),gastroduodenum ulcer(6)and uraemic gastrointestinal ero- sion(6).Routing SPECT for determing the hemorrhagic sites was introduced.The multiple-site and lower intestine hemorrhage could easily be found by SPECT.The combined hemostatic treat- ments should be used.Surgical treatment was suitable in strictly selected indications.The diffe- rential diagnosis should be made for the perigraft bleeding which had similar phenomena to that of graft rupture.Emergent operation was needed in most of these cases.The rupture rate could be markedly reduced by the section of the perirenaI fascia(P<0.01).The latero-and retro-peritoneal hemotoma were easily formed and should be noticed with emphasis in diagnosis and management.
出处
《中华器官移植杂志》
CAS
CSCD
1996年第3期117-119,共3页
Chinese Journal of Organ Transplantation
关键词
肾移植
并发症
消化道出血
Renal/transplantation
Complication
Kidney diseases
Gastrointestinal hemorrhage
