目的：总结移植肾动脉血管并发症的临床特点与治疗经验。方法2007年6月至2014年6月解放军281医院收治的322例肾移植患者中，29例肾移植患者术后出现移植肾动脉血管并发症。对29例移植肾血管并发症患者的临床资料进行回顾性分析，总结该病的临床特点及治疗经验。结果移植肾动脉吻合口出血 2例，移植肾内动脉痉挛23例，移植肾动脉血栓形成 2例，移植肾动脉狭窄 2例。移植肾动脉吻合口出血患者为术后动脉吻合口出血，予及时手术探查止血。移植肾内动脉痉挛患者，术中给予抗痉挛处理后移植肾由暗红、质地软转为饱满红润。移植肾动血栓形成患者，确诊后立即进行手术探查，移植肾呈暗红色，恢复血供后仍未恢复正常，予以切除。移植肾动脉狭窄，采用球囊扩张及支架置入术，患者血压恢复正常，肾功能正常。结论移植肾动脉血管并发症进展迅速，病情变化快且后果严重，为降低其发生率，提高治愈率，积极预防和果断处理十分重要。%Objective To summarize the clinical characteristics and treatment experience on vascular complications of transplant renal artery.Methods Of 322 patients undergoing renal transplantation in the 281st Hospital of People's Liberation Army from June 2007 to June 2014,29 patients developed vascular complications of transplant renal artery after transplantation. Clinical data of such 29 patients were retrospectively studied to summarize the clinical characteristics and treatment experience.Results Two patients developed anastomotic haemorrhage of transplant renal artery,23 patients developed transplant intrarenal artery spasm,2 patients developed transplant renal artery thrombosis and 2 patients developed transplant renal artery stenosis.The anastomotic haemorrhage from transplant renal artery was postoperative haemorrhage,and surgical exploration and hemostasis were conducted in time. Patients with transplant intrarenal artery spasm were given antispasmodic treatment during operation.And the dark red and soft renal graft became full and ruddy.Patients with transplant renal artery thrombosis underwent surgical exploration once confirmed.The renal grafts were dark red and did not recover to normal after blood supply recovery,thus the renal grafts were removed.For patients with developed transplant renal artery stenosis,balloon dilatation and stent implantation were adopted.The blood pressure of patients returned to normal and the renal function was normal.Conclusions Vascular complications of transplant renal artery are characterized by quick progression, fast condition changes and serious consequences.In order to reduce the incidence and increase the recovery rate,active prevention and decisive treatment are very important.
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