CAJ | 학술논문

目的比较输尿管-膀胱吻合和输尿管-输尿管端端吻合在肾移植术后发生并发症的情况.方法选择2005年1月至2008年10月接受同种异体肾移植患者80例.按尿路重建方式分为输尿管-膀胱吻合组和输尿管-输尿管吻合组,每组40例.观察术后患者尿瘘、膀胱输尿管返流、输尿管梗阻及反复尿路感染等并发症发生情况.结果输尿管-膀胱吻合组术后随访13～46(24.5±8.9)个月,输尿管-输尿管吻合组术后随访13～46(26.0±7.2)个月.输尿管-膀胱吻合组发生尿路并发症10例,发生率为25.0%(10/40);输尿管-输尿管吻合组发生尿路并发症4例,发生率为10.0%(4/40),两组比较差异无统计学意义(P＞0.05).输尿管-膀胱吻合组和输尿管-输尿管吻合组尿瘘发生率分别为2.5%(1/40)和5.0%(2/40)(P＞0.05),膀胱输尿管返流发生率分别为10.0%(4/40)和0(P<0.05),输尿管梗阻发生率分别为0和5.0%(2/40)(P＞0.05),反复尿路感染发生率分别为12.5%(5/40)和0(P<0.05).结论输尿管-输尿管端端吻合与广泛使用的输尿管-膀胱吻合相比,膀胱输尿管返流、反复尿路感染的发生率较低,可以作为肾移植尿路重建的首选方法.
목적 비교수뇨관-방광문합화수뇨관-수뇨관단단문합재신이식술후발생병발증적정황.방법 선택2005년1월지2008년10월접수동충이체신이식환자80례.안뇨로중건방식분위수뇨관-방광문합조화수뇨관-수뇨관문합조,매조40례.관찰술후환자뇨루、방광수뇨관반류、수뇨관경조급반복뇨로감염등병발증발생정황.결과 수뇨관-방광문합조술후수방13～46(24.5±8.9)개월,수뇨관-수뇨관문합조술후수방13～46(26.0±7.2)개월.수뇨관-방광문합조발생뇨로병발증10례,발생솔위25.0%(10/40);수뇨관-수뇨관문합조발생뇨로병발증4례,발생솔위10.0%(4/40),량조비교차이무통계학의의(P＞0.05).수뇨관-방광문합조화수뇨관-수뇨관문합조뇨루발생솔분별위2.5%(1/40)화5.0%(2/40)(P＞0.05),방광수뇨관반류발생솔분별위10.0%(4/40)화0(P<0.05),수뇨관경조발생솔분별위0화5.0%(2/40)(P＞0.05),반복뇨로감염발생솔분별위12.5%(5/40)화0(P<0.05).결론 수뇨관-수뇨관단단문합여엄범사용적수뇨관-방광문합상비,방광수뇨관반류、반복뇨로감염적발생솔교저,가이작위신이식뇨로중건적수선방법.
Objective To compare complications of ureteroneocystostomy and end-to-end ureteroureterostomy after kidney transplantation. Methods Eighty allograft renal transplantation patients between January 2005 and October 2008 were divided into two groups according to urinary tract reconstruction approach: ureteroneocystostomy group (40 cases) and ureteroureterostomy group (40 cases). Complications including leakage of urine,vesicoureteral reflux,obstruction of ureter and urinary tract infection were recorded.Results In ureteroneocystostomy group and ureteroureterostomy group,the patients were followed up for 13 - 46 (24.5 ± 8.9), 13 - 46 (26.0 ± 7.2) months postoperatively, urinary complications were recorded for 10 eases (25.0%, 10/40) and 4 cases (10.0%, 4/40)(P > 0.05), incidence of leakage of urine were 2.5%(1/40)and 5.0%(2/40) (P > 0.05), vesicoureteral reflux were 10.0% (4/40) and 0 (P ＜ 0.05), obstruction of ureter were 0 and 5.0% (2/40) (P > 0.05), and urinary tract infection were 12.5% (5/40) and 0 (P < 0.05).Conclusions Compared with ureteroneoc ystostomy, ureteroureterostomy can reduce the incidence of vesicoureteral reflux and urinary tract infection,it can be regarded as the first choice for urinary tract reconstruction after kidney transplant recipients.