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目的 探讨多囊肾患者肾移植的特点、不切除原双侧肾脏的可行性及其对移植效果的影响。方法 总结了 2 8例多囊肾患者肾移植的临床研究结果。最大年龄 6 2岁 ,平均 5 6 .2岁 ;透析时间 3～ 18个月。移植术前、术中及术后均未切除原双侧肾脏 ,移植后观察肾脏体积及血尿的变化 ,采取积极的防治感染措施。结果 1年人肾存活率均为 95 .2 % ,3年存活率 85 .7% ,最长存活已 9年 ;急性排斥反应的发生率 10 .7%。移植后原肾脏体积逐渐缩小 ,血尿逐渐消失。结论 多囊肾患者接受肾移植 ,其主要表现不是影响移植效果的重要因素和移植后的主要并发症 ,不切除原病变肾脏能收到满意的移植效果。移植后只要严密观察多囊肾的血尿、感染等表现并采取积极有效的防治措施 ,多囊肾的表现多能减轻或消失 ,肾脏体积明显缩小 ,移植肾功能稳定。
Objective To investigate the characteristics of kidney transplantation in patients with polycystic kidney disease, the feasibility of not removing the original bilateral kidney and its effect on the transplantation effect. Methods The clinical results of renal transplantation in 28 patients with polycystic kidney disease were summarized. The maximum age of 6 2 years old, with an average of 56.2 years; dialysis time of 3 to 18 months. Before transplantation, the original bilateral kidneys were not resected before and after operation. The changes of renal volume and hematuria were observed after transplantation. Positive measures were taken to prevent and treat the infection. Results One-year human renal survival rate was 95.2%, the 3-year survival rate was 85.7%, the longest survival rate was 9 years and the incidence of acute rejection was 10.7%. The original kidney volume gradually reduced after transplantation, hematuria gradually disappear. Conclusions Polycystic kidney disease patients underwent renal transplantation. The main manifestations of polycystic kidney disease patients were not the important factors that affected the transplantation effect and the main complications after transplantation. The excision of the original diseased kidney could receive a satisfactory transplantation effect. As long as the strict observation of the polycystic kidney transplant hematuria, infection and other performance and take active and effective prevention and treatment measures, polycystic kidney more than able to reduce or disappear, significantly reduced the size of the kidney, renal transplant function and stability.