移植肾输尿管狭窄的临床诊治及预防措施分析

目的 探讨肾移植术后移植肾输尿管狭窄的临床诊治及预防措施。方法 回顾性分析2013年1月至2015年4月安徽医科大学第一附属医院移植中心收治的肾移植术后移植肾输尿管狭窄5例患者的临床资料，并结合文献进行分析。结果 经B超及移植肾输尿管造影等检查，5例患者均存在不同程度的移植肾输尿管狭窄，其中4例行移植肾输尿管膀胱再植术，1例行移植肾输尿管双J管置入术，术后移植肾功能均恢复。结论 对于肾移植术后出现少尿、肌酐进行性升高的患者，应及早行移植肾B超、移植肾输尿管造影及CT尿路造影等检查，明确有无狭窄及狭窄位置，移植肾输尿管膀胱再植术及输尿管双J管置入术是有效的治疗方法，若在手术过程中注意某些环节，则可减少部分移植肾输尿管狭窄的发生。

Clinical diagnosis and treatment and preventive measures of ureteral stenosis after renal transplantation: a report of 5 cases

Objective To investigate the clinical diagnosis,treatment and preventive measures of ureteral stenosis after renal transplantation.Methods A respective study was performed on 5 cases of ureteral stenosis who received renal allografts in our transplant department,and the clinical data were analyzed through literature review.Results All five patients were diagnosed as ureteral stenosis by ultrasound,kidney transplant ureterography and so on.Four patients underwent open surgical management,and D-J stent in ureter was performed on the other patient.Renal function of all patients was recovered postoperatively.Conclusion Ultrasound,kidney transplant ureterography and CTU should be taken timely for these patients with oliguria and elevated serum creatinine.Both ureter bladder replantation and D-J stent insertion are effective methods.The occurrence rate of ureteral stenosis can be reduced via taking some steps during the operation.