Trapeznikova M F, Filiptsev P Ia, Perlin D V, Urenkov S B, Kulachkov S M
Urol Nefrol (Mosk). 1994 May-Jun(3):42-5.
Ureteral strictures in kidney recipients are serious urological complications often responsible for the transplant rejection and sometimes for the recipient's death. The stricture-related slight and nonspecific symptoms often underlie its late diagnosis and inadequate treatment. Obligatory follow-up ultrasonic investigations promote early detection of ureteral stenosis. Eight kidney recipients with ureteral stricture initially underwent transcutaneous puncture nephrostomy preserving the transplant function and preventing aggravation of the condition. In view of threatening infection and weak reparative capacity of immunosuppressed patients, less traumatic transcutaneous interventions seem preferable in further treatment: bouginage, balloon dilatation or the stricture dissection followed by insertion of the inner stent. In uneffective transcutaneous surgery due to extended ureteral strictures or complete obstruction of the ureter it is valid to conduct pyeloureterostomy with the recipient's own ureter.
肾移植受者的输尿管狭窄是严重的泌尿系统并发症,常导致移植排斥反应,有时甚至导致受者死亡。与狭窄相关的轻微且非特异性症状往往导致其诊断延迟和治疗不足。必要的随访超声检查有助于早期发现输尿管狭窄。8例输尿管狭窄的肾移植受者最初接受了经皮穿刺肾造瘘术,以保留移植肾功能并防止病情加重。鉴于免疫抑制患者存在感染风险且修复能力较弱,在进一步治疗中,创伤较小的经皮干预似乎更为可取:如探条扩张术、球囊扩张术或狭窄切除术,随后置入内支架。对于因输尿管狭窄延长或输尿管完全梗阻导致经皮手术无效的情况,采用受者自身输尿管进行肾盂输尿管吻合术是有效的。