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目的探讨儿童肾移植的手术特点、术后并发症及免疫抑制治疗方案。方法回顾性研究1998年2月至2004年12月46例儿童肾移植患者的临床资料。观察受者及移植肾存活情况,受者生长发育情况及术后并发症。结果46例儿童肾移植后发生急性排斥反应10例,肾功能延迟恢复4例,尿漏1例,肝功能损害8例,肺部感染8例,全骨髓抑制3例,粒细胞减少2例,输尿管坏死1例,移植肾动脉狭窄1例。术后4周所有患者肾功能均恢复正常。术后1年人和移植肾存活率均为100%,3年人和移植肾存活率分别为100%和97.4%。结论肾移植是治疗儿童终末期肾病的有效手段。儿童肾移植术后急性排斥发生率高,免疫抑制治疗应根据不同个体的特点制定不同的方案。
Objective To investigate the surgical characteristics of children with renal transplantation, postoperative complications and immunosuppressive treatment programs. Methods The clinical data of 46 children with renal transplantation from February 1998 to December 2004 were retrospectively studied. To observe the survival of recipients and transplant recipients, the growth and development of recipients and postoperative complications. Results 46 cases of children with acute rejection after renal transplantation in 10 cases, delayed recovery of renal function in 4 cases, 1 case of urinary leakage, liver dysfunction in 8 cases, 8 cases of pulmonary infection in 3 cases of bone marrow suppression, neutropenia in 2 cases, 1 case of ureteral necrosis, 1 case of renal artery stenosis. All patients returned to normal after 4 weeks. The survival rate of human and transplanted kidney was 100% at 1 year after operation, and the survival rates of 3-year human and transplanted kidney were 100% and 97.4% respectively. Conclusion Kidney transplantation is an effective treatment for children with end-stage renal disease. Children with acute rejection after renal transplantation a high incidence of immunosuppressive therapy should be based on the characteristics of different individuals to develop different programs.