移植肾动脉造影和栓塞术在临床失功移植肾处理中的应用

目的:探讨肾动脉造影和栓塞术在临床失功移植肾处理中的应用.方法:对移植肾失功拟停用免疫抑制剂的8例患者行移植肾动脉造影检查,其中5例进行移植肾动脉栓塞治疗.观察肾动脉栓塞并停用免疫抑制剂后的临床效果.结果:移植肾动脉造影3例动脉未显影,未进行移植肾动脉栓塞治疗;5例进行移植肾动脉栓塞治疗,其中3例停用全部免疫抑制剂,1例小剂量激素维持,1例因持续发热、移植肾疼痛手术切除.栓塞病例出现"栓塞后综合征".结论:对拟停用免疫抑制剂的移植肾失功患者,有必要进行移植肾动脉造影检查;有血流信号者可行移植肾动脉栓塞术替代移植肾切除术.该方法治疗可能避免手术和手术所带来风险.

Significance of contrast examination and embolism of renal artery for treating posttransplanted renal failure

Objective: To investigate the significance of kidney artery contrast examination and embolism of renal artery for treating post-transplanted renal failure? Methods: The contrast examination of renal artery was carriedout in 8 patients who had post-transplanted renal failure and would stop immunosuppressant. Among the 8 patients,5 patients were treated with renal artery embolism. The effect of therapy of embolism and withdrawal of immunosuppressant were ohserved. Results: 3 cases renal artery conld not be found,theve was no way to do the embolism;5 cases were undrgone embolism of the renal artery, 3 of them were given a withdrawal of immunosupressant, 1 of them need to take a low dosage of hormone and 1 of them has a resection of implanted kidney because of a persisted fever and pain. All the patients with embolism had "post-embolism syndrome". Conclusion: It is necessary to give the renal artery contrast examination to patients who have post-transplanted renal failure and will stop the immunosuppressant;The embolism of renal artery may replace the resection of graft. This method may avoid the operation and decress the risk.