摘要
目的探讨进行心脏死亡后器官捐献(DCD)供肾移植时,选择髂内动脉或髂外动脉吻合方式对肾功能及血液灌注的影响。方法选取自2016年1月至2018年1月收治的尿毒症行DCD供肾移植术患者103例为研究对象。根据动脉吻合方式将患者分为髂内动脉端端吻合组(A组,n=41)和髂外动脉端侧吻合组(B组,n=62)。两组患者术后应用抗排斥药物方案相同。随访3个月,比较两组患者的肾功能(血肌酐水平)、彩色多普勒肾血流参数(肾动脉内径,主肾动脉、段动脉及大叶间动脉收缩期血液峰值流速、舒张期末血液流速及血管阻力指数)。结果两组患者的血肌酐水平,肾动脉内径,主肾动脉、段动脉及大叶间动脉收缩期血液峰值流速、舒张期末血液流速及血管阻力指数比较,差异均无统计学意义(P> 0. 05)。结论肾移植动脉重建选择髂内外动脉对DCD供肾移植肾功能及血液灌注情况均无明显影响,动脉吻合方式选择可视情况而定。
Objective To investigate the effects of internal iliac artery or external iliac artery anastomosis on renal function and blood perfusion in kidney transplantation with donation after cardiac death（DCD）.Methods A retrospective study was performed on 103 cases of patients with uremia who underwent DCD transplantation of kidney from January 2016 to January 2018.According to the arterial anastomosis method,the patients were divided into the iliac internal artery end-to-end anastomosis group（Group A, n =41）and the external iliac artery end-to-end anastomosis group（Group B, n =62）.The two groups of patients were treated with the same anti-rejection drug regimen after surgery.Patients were followed up for 3 months to compare renal function（serum creatinine level）and renal blood flow parameters（renal artery diameter,peak blood flow rate at systolic stage of main renal artery,segmental artery and interlobular artery,blood flow rate at diastolic end and vascular resistance index）.
Results The blood creatinine level,renal artery diameter,peak blood flow rate at systolic stage of main renal artery,segmental artery and interlobular artery,blood flow rate at diastolic end and vascular resistance index of the two groups were not statistically significant different（ P 〉0.05）.Conclusion The choice of internal or external iliac artery for renal artery reconstruction had no significant effect on the function of DCD graft and blood perfusion,and the selection of arterial anastomosis is determined by the visusl condition.
作者
徐会青
何龙
陈鹏
杨宏伟
XU Hui-qing;HE Long;CHEN Peng;YANG Hong-wei(Graduate School of Jinzhou Medical University,Jinzhou 121001,China)
出处
《临床军医杂志》
CAS
2018年第11期1337-1339,共3页
Clinical Journal of Medical Officers
关键词
心脏死亡后器官捐献
肾移植
动脉吻合
血液灌注
Donation after cardiac death
Kidney transplantation
Arterial anastomosis
Hemoperfusion
