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目的探讨离体肾动脉瘤修补、肾动脉重建和自体肾移植技术治疗复杂性孤肾肾动脉瘤的安全性和可行性。方法 CT血管造影(CTA)确诊复杂性孤肾肾动脉瘤1例,病变位于肾动脉主干分叉部,累及节段分支动脉,深入肾门内。肾脏暂时性离体后,在低温和肾脏灌注液灌注保护肾脏的前提下,体外进行肾动脉瘤修补和自体大隐静脉肾动脉重建,然后将肾脏异位移植到右侧髂窝。结果手术成功,围手术期无严重并发症发生。术后血肌酐暂时性升高至约200μmol/L,半个月后逐渐恢复正常;术后2周复查 CTA 示右髂窝移植肾动脉及其分支血流通畅无狭窄,肾静脉回流通畅,输尿管无狭窄。结论该方法治疗复杂性孤。肾肾动脉瘤安全可行,并为以后类似的复杂性。肾脏疾病的处理提供了可行方法。
Objective To investigate the safety and feasibility of ex vivo renal aneurysm repair, renal artery reconstruction and autologous renal transplantation in the treatment of complex orbital renal artery aneurysm. Methods CT angiography (CTA) was performed in 1 patient with complicated orbital renal artery aneurysm. The lesion was located in the bifurcation of the renal artery, involving the branch artery and penetrating into the renal portal. The kidneys were transiently ex vivo and renal artery aneurysm repair and autologous saphenous vein renal artery reconstruction was conducted in vitro under hypothermia and perfusion of kidney perfusion to protect the kidneys. The kidneys were then heterotopic transplanted to the right iliac fossa. Results The operation was successful. No serious complications occurred during the perioperative period. Postoperative serum creatinine temporarily increased to about 200μmol / L, gradually returned to normal after half a month; 2 weeks after the CTA showed the right common iliac fossa graft renal artery and its branches flow was smooth and stenosis, renal vein reflux patency, ureter narrow. Conclusion The method of treating complex orphans. Renal and renal aneurysms are safe and viable, with similar complications for the future. Treatment of kidney disease provides a viable approach.