尸肾移植术后肾功能延迟恢复不同病因的超声诊断

目的：探讨尸肾移植后肾功能延迟恢复不同病因的超声表现。方法：总结分析３７例病因不同、诊断明确的移植肾功能延迟恢复（ＤＧＦ）患者的彩色多普勒超声资料，并与３０例肾移植后肾功能及时恢复者对照。结果：（１）ＤＧＦ者的主肾动脉、段动脉的峰速度、加速度、阻力指数均明显增加（Ｐ＜０．０５、Ｐ＜０．０１）；（２）急性排异者峰速度与舒张期速度的差值较大，其差值占峰速度的７８％以上，肾后梗阻者叶间动脉频谱呈“锯齿”状，阻力指数均小于０．５５；（３）急性肾小管坏死者肾皮质彩色血流信号相对稀少，肾髓质内示多条动静脉短路花色血流信号；急性排异者肾叶间动脉及弓形动脉血流信号不连续脉冲性花色血流信号间存在血流信号的中断；肾后性梗阻者叶间动脉似“脉冲型静脉血流”收缩期与舒张期血流信号的色彩变化较小。结论：应用彩色多普勒超声可辨别引起ＤＧＦ的三种常见病因。

Etiological Ultrasonic Diagnosis of Delayed Recovery of the Rena l Function after Cadaveric Kidney Transplantation

Objective: To inquire into the ultrasonic display of different causes that leaded to delayed graft function(DGF)of patients with kidney transplantation. Methods: To summarize the color Doppler ultrasonic data of 37 patients with delayed graft function(DGF)and compared with those 30 immediate recovery cases. Results: 1.The peak velocity,the acceleration resistance index of renal artery and segmental artery in DGF patients were obviously increased(P<005,P<001);2The difference of velocity between peak velocity and diastolic speed was more than that in patients with acute rejection,constituted 78% of the peak velocity.The frequency of interlobar artery in postrenal obstruction was similar to "Sawtooth" and the resistant index was less than 055.3.The color signal of the renal cortex blood flow was relative scarce in patients with acute necrosis of renal tubules.There were many different color arteriovenous blood flow signals in the kidney medulla.The interruption of the signals developed in the interlobar and arch artery flow of the acute rejection.The blood flow of the interlobar artery of the postrenal obstruction was similar to the "pulse type venous flow".The color changes of the blood flow signals were less in the systolic and diastolic phases. Conclusion: Color Doppler ultrasonography can recognize the causes leading DGF as mentioned above.