摘要
目的探讨血管介入治疗对移植肾动脉狭窄(transplanted renal arterial stenosis,TRAS)的疗效。方法回顾性分析本中心513例肾移植患者中并发TRAS的患者资料,比较血管介入治疗前、后的1周、1个月、3个月、6个月,患者的肌酐、血压及移植肾血流动力学指标的变化。结果513例肾移植患者中有9例并发TRAS,发生率为1.75%,9例患者均行血管介入治疗,其中8例患者单纯行球囊扩张术,1例患者行球囊扩张后置入血管支架。8例球囊扩张术的患者有3例术后2个月内再次出现狭窄,二次狭窄率为33.3%,再次给予球囊扩张均成功。所有患者随访6个月,1例患者血管介入治疗后4个月因肺部感染死亡。治疗前患者血肌酐为(142.3±59.6)μmol/L,治疗后1周、1个月、3个月、6个月分别为(133.5±57.2)μmol/L、(131.8±35.6)μmol/L、(127.0±29.9)μmol/L、(125.7±37.1)μmol/L,与术前相比,无统计学差异,但有下降趋势。治疗前患者收缩压为(149.7±19.3)mmHg(1 mmHg=0.133 kPa),治疗后1周、1个月、3个月、6个月分别为(131.3±4.1)mmHg、(136.2±7.9)mmHg、(128.5±6.6)mmHg、(127.1±3.6)mmHg,与术前相比,收缩压明显降低,具有统计学差异。治疗前患者移植肾主动脉峰值流速(peak systolic velocity,PSV)为(297.2±105.3)cm/s,治疗后1周、1个月、3个月、6个月分别(171±56.3)cm/s、(185.8±64.8)cm/s、(197.5±69.1)cm/s、(178.8±75.4)cm/s,与术前相比,均具有统计学差异。治疗后1周、1个月、3个月、6个月的叶间PSV、叶间动脉阻力指数,与术前相比,无统计学差异。结论血管介入治疗的疗效确切,能有效改善TRAS患者移植肾功能。
Objective To investigate the effect of vascular interventional therapy on transplanted renal arterial stenosis(TRAS).Methods The patients with concurrent TRAS among 513 patients with renal transplantation were retrospectively enrolled.The changes of creatinine,blood pressure and hemodynamic index of transplanted renal hemography in patients 1 week,1 month,3 months,and 6 months after treatment were compared.Results Of the 513 patients with kidney transplantation,9 experienced concurrent TRAS,with an incidence rate of 1.75%.The 9 patients were treated with vascular interventional treatment,8 patients received simple balloon expansion and 1 patient was implanted with vascular stents after balloon expansion.In patients with cystic dilation,3 cases recurred within 2 months of surgery,with a secondary stenosis rate of 33.3%,and the secondary cystic dilation was successful.All patients were followed up for 6 months,and one patient died of lung infection 4 months after vascular intervention therapy.Blood creatinine in pre-treatment patients was(142.3±59.6)μmol/L,and were(133.5±57.2)μmol/L,(131.8±35.6)μmol/L,(127.0±29.9)μmol/L,(125.7±37.1)μmol/L at 1 week,1 month,3 months,6 months after treatment,respectively.Although there is no statistical difference,there is a downward trend after treatment.Pre-treatment systolic pressure was(149.7±19.3)mmHg(1 mmHg=0.133 kPa),the value were(131.3±4.1)mmHg,(136.2±7.9)mmHg,(128.5±6.6)mmHg,(127.1±3.6)mmHg at 1 week,1 month,3 months,6 months after treatment.Systolic pressure was significantly reduced compared with pre-treatment level.The Pre-treatment transplanted renal aortic peak systolic velocity(PSV)was(297.2±105.3)cm/s,the velocity were(171±56.3)cm/s,(185.8±64.8)cm/s,(197.5±69.1)cm/s,(178.8±75.4)cm/s at 1 week,1 month,3 months,6 months after treatment,There are statistical differences compared with pre-treatment.The interfolate arterial PSV,interfolate artery resistance index were similar at 1 week,1 month,3 months,6 months after treatment compared to preoperative
作者
李树欣
赵永恒
陈文忠
胡伟
周允冲
宋永琳
马寅锐
孙洵
Li Shuxin;Zhao Yongheng;Chen Wenzhong;Hu Wei;Zhou Yunchong;Song Yonglin;Ma Yinrui;Sun Xun(Department of Urology,First People,s Hospital of Kunming,Kunming 650000,Yunnan,China;Department of Interventional Radiology,First People,s Hospital of Kunming,Kunming 650000,Yunnan,China)
出处
《实用器官移植电子杂志》
2020年第2期106-109,共4页
Practical Journal of Organ Transplantation(Electronic Version)
关键词
肾移植
移植肾动脉狭窄
血管介入治疗
Kidney transplantion
Transplanted renal arterial stenosis
Vascular interventional therapy
