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器官捐献移植肾动脉细菌感染破裂的诊疗对策

高建 张媛 成伟丽 禹猛 姜伟 刘彦斌 牛宏燕

高建, 张媛, 成伟丽, 等. 器官捐献移植肾动脉细菌感染破裂的诊疗对策[J]. 器官移植, 2017, 8(4): 311-313, 332. doi: 10.3969/j.issn.1674-7445.2017.04.012
引用本文: 高建, 张媛, 成伟丽, 等. 器官捐献移植肾动脉细菌感染破裂的诊疗对策[J]. 器官移植, 2017, 8(4): 311-313, 332. doi: 10.3969/j.issn.1674-7445.2017.04.012

器官捐献移植肾动脉细菌感染破裂的诊疗对策

doi: 10.3969/j.issn.1674-7445.2017.04.012
详细信息
    通讯作者:

    张媛, Email:523097476@qq.com

  • 中图分类号: R617, R63

  • 摘要:   目的  探讨移植肾动脉细菌感染破裂的诊疗方案。  方法  回顾性研究4例肾移植术后因细菌感染导致移植肾动脉破裂患者的临床资料, 并检索相关文献进行综合分析。  结果  患者临床表现为突然出现的移植肾区肿胀, 不同程度疼痛, 引流管引流出鲜红色血液或沿切口缝合线渗出鲜红色血液, 移植肾彩色多普勒超声检查提示移植肾周血肿。4例患者均行手术探查, 同期切除移植肾, 标本进行细菌培养, 4例均为细菌感染, 均行髂外动脉感染破裂修补术。1例术后恢复血液透析, 等待再次移植; 1例因术后并发腹腔严重感染死亡; 2例因失血性休克死亡。  结论  移植肾动脉感染导致动脉破裂出血的病情凶险, 需要急诊手术治疗, 病死率较高。应严格执行器官供体选择标准, 供体器官灌注液进行细菌培养, 围手术期加强抗感染, 预防术后感染性移植肾动脉破裂的发生。

     

  • 表  1  4例移植肾动脉破裂患者的临床资料

    Table  1.   Clinical data of 4 cases with arteriorrhexis of transplant kidney

    例序 年龄(岁) 术后首次出血时间(d) 出血次数(次) 细菌培养结果 治疗前Scr(μmol/L) 治疗 结局
    1 28 12 3 大肠埃希菌 101 抗感染及手术缝合 死亡
    2 48 12 5 肺炎克雷伯杆菌 245 抗感染及手术缝合 死亡
    3 48 39 1 肺炎克雷伯杆菌 465 抗感染及手术缝合 恢复透析
    4 62 21 1 成团肠杆菌属 421 抗感染及手术缝合 死亡
    下载: 导出CSV
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出版历程
  • 收稿日期:  2017-03-20
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2017-07-15

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