肾移植术后早期输尿管梗阻及处理

目的 分析肾移植术后早期移植肾输尿管梗阻，致移植肾积水的病因。方法 收集并分析自1993年至今的250例肾移植的临床资料，其中尸体供肾240例，活体供肾10例。术后12W内因输尿管梗阻导致移植肾积水8例（3.2％）。结果 1例保守治疗，7例明确病因后再次手术解除梗阻，术看病情改善，移植肾功能恢复，随访8个月无复发。结论 肾移植术后近期移植肾输尿管梗阻多与外科因素有关，需从取肾到移植输尿管膀胱吻合的各个环节加以注意，以减少输尿管梗阻的发生，手术是解除术后输尿管梗阻的主要手段。

Analysis on the cause and treatment of ureteral obstruction in early period after kidney transplantation

Objective To analyse the cause and treatment of ureteral obstruction in early period after kidney transplantation.Methods 250 cases of kidney transplantation from 1993 to 2007, including 141 men and 109 women, 240 cadaver donor transplantations and 10 living donor transplantations. Were collected and analysed. Results Transplant ureteral obstruction occurred in 8 cases（3.2%） in the early stage following renal transplantation,B type ultrasonography,ECT,MRU and surgical exploration were used to find the obstruction position and the cause.7cases needed another surgical operation to relieve the obstruction and the renal function recovered in these cases ,8- monthcs follow-up showed no recurrence in all the cases. Conclusions The ureteral obstruction in the early phase of kidney transplantation was mostly contributed to the surgical reasons such as mis-perfomance.The occurance rate of ureteraloltstruction would be reduced if care is taken in each step of the kidney transplantation. The surgical management is a direct and effective method to relieve the obstruction .