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目的:探讨肾移植术后早期无尿或少尿的原因及诊治方法。方法:回顾性分析66例肾移植术后早期无尿或少尿患者的发生情况,并分别应用以FK506或CsA为主的免疫抑制剂(FK506/CsA+MMF+Pred)等综合治疗方案。结果:66例肾移植术后早期无尿或少尿的主要原因是急性肾小管坏死(77.27%),其次是急性排斥反应(10.61%),其中有2例移植肾原发无功能和移植肾破裂、肾动脉栓塞各1例术后切除移植肾。FK506组的34例移植肾功能在术后5～35天内均恢复正常;CsA组有1例因急性排斥反应合并严重肺部感染而死亡,24例移植肾功能在术后7～48天内均恢复正常,3例血肌酐在142～215μmol/L之间。结论:肾移植术后早期出现无尿或少尿后应及时分析原因,并给予相应的综合治疗。FK 506+MMF+Pred的三联免疫治疗有助于移植肾功能的早期恢复。
Objective: To investigate the causes and diagnosis and treatment of anuria or oliguria after renal transplantation. Methods: The incidence of early anuria or oliguria in 66 patients after renal transplantation was retrospectively analyzed. The comprehensive treatment regimen including FK506 or CsA-based immunosuppressive agents (FK506 / CsA + MMF + Pred) were applied. Results: The main causes of early anuria or oliguria in 66 cases of renal transplantation were acute tubular necrosis (77.27%), followed by acute rejection (10.61%), of which 2 cases had primary renal failure and graft kidney One case of rupture and one case of renal artery embolization were resected. In the FK506 group, 34 cases of transplant renal function returned to normal within 5 to 35 days after operation; 1 case died of acute rejection and severe pulmonary infection in CsA group, and 24 cases of transplant kidney function recovered within 7 to 48 days after operation Normal, 3 cases of serum creatinine between 142 ~ 215μmol / L. CONCLUSIONS: The causes of anuria or oliguria should be promptly analyzed after renal transplantation and the corresponding comprehensive treatment should be given. Triple immunotherapy with FK 506 + MMF + Pred contributes to early recovery of renal graft function.