移植肾间室综合征四例报道

目的 探讨移植肾间室综合征的诊断方法和处理原则.方法 分析和总结4例患者发生移植肾问室综合征的危险因素以及诊断和处理方法.结果 2例由于腹胀,1例由于腰骶部挚起,1例南于再次肾移植盆腔容积狭小,腹壁张力增高而导致腹膜后压力升高,压迫移植肾,引起移植肾血液循环障碍,导致移植肾功能紊乱.彩色多普勒超声检查提示移植.肾皮质血流减少,移植肾各级动脉血流速度降低和阻力指数增高.经迅速解除引起腹膜后压力升高的危险因素,减轻腹膜后的压力,改善移植肾微循环,4例移植肾室综合征患者的肾功能均恢复正常.结论 移植肾间室综合征是肾移植术后的一种近期并发症.彩色多普勒超声检查可明确诊断;确诊后应紧急减轻腹膜后的压力,解除移植.肾受压可改善患者的预后.

Diagnosis and treatment of renal allograft syndrome

Objective To investigate the diagnosis and treatment of renal allograft compartment syndrome(RACS)．Methods The risk factor，diagnosis and treatment were analyzed in 4 patients with RACS after kidney transplantation．Results RACS was caused by abdominal distension in 2 cases，by pad under lumbosacral area in 1 case，by the decreased cavity of pelvis in 1 case．Resulting in increased abdominal wall tension．Doppler ultrasound examination showed the reduction of blood supply in the kidney cortex，decreased arterial blood flow rate in transplanted kidney and the increased resistant index,Aher the risk factors resulting in the retroperitoneal pressure were withdrawn．The retroperitoneal pressure was reduced and the microcirculation of the transplanted kidney was improved，the renal function in 4 patients with RACS was fully recovered．Conclusions RACS iS a kind of short-term complication after kidney transplantation．Doppler ultrasound examination can confirm the diagnosis of RACS．Urgentreduction of the retroperitoneal pressure can improve the prognosis of patients undergoing kidney transplantation.