肾移植术后髂外动脉血管并发症的诊治体会（附6 例病例报告）

目的：探讨肾移植术后髂外动脉血管并发症的特点和诊治经验。方法：回顾2001年至2013年中南大学湘雅 三医院移植中心2 000余例肾移植患者中6例肾移植术后髂外动脉血管并发症患者的临床资料，对其临床特点及诊治方 法进行分析总结。结果：6例患者中5例因反复髂外动脉出血切除移植肾，其中2例患者行自体大隐静脉逆转替代髂外 动脉术，2例患者行双侧股动脉血管搭桥术，1例直接行髂外动脉修补术；另1例患者因髂外动脉真菌包块切除了移植 肾及所累及处的髂外动脉，动脉缺损处用尸体髂动脉行原位搭桥术。6例患者中除1例髂外动脉修补术后死亡外，其余5 例患者均存活。结论：血管替代法及动脉搭桥法是抢救肾移植术后髂外动脉血管并发症患者较为有效的方法。

Diagnosis and treatment of vascular complications of external iliac arteries after kidney transplantation:#br# a report of 6 cases

Objective: To explore the characteristics of external iliac artery vascular complications after renal transplantation and the diagnosis and treatment. Methods: We reviewed the clinical data of 6 patients with of external iliac artery vascular complications after renal transplantation from more than 2000 renal transplantation patients in the Transplantation Center of the Third Xiangya Hospital of Central South University from 2001 to 2013, and analyzed the clinical characteristics, diagnosis and treatment. Results: The renal allograft was removed in 5 of the 6 patients due to repeated external iliac artery hemorrhage: 2 patients were replaced the external iliac artery with reversed autogenous great saphenous vein, 2 patients underwent the bilateral femoral artery bypass surgery, and 1 was repaired the external iliac artery directly. The other 1 was resected the renal allograft and the involved external iliac arteries due to fungal mass in the external iliac artery. Among the 6 patients, except 1 patient died after the surgery of the repair of the external iliac artery, the other 5 are all alive. Conclusion: Vascular replacement and artery bypass are effective methods for patients with external iliac artery vascular complications after kidney transplantation.