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移植肾出血一例
大外科
![](https://pub-med-avatar.medlinker.com/1535598749xaz6kmhh.jpg)
廖医师![](data:image/png;base64,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)
![](data:image/png;base64,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)
中山大学附属第三医院
主诉 病史
患者肾移植术后5天,移植肾周肿胀2天。患者5天前在我院行异体肾移植术,术后移植肾功能恢复良好,肌酐缓慢下降,今日患者诉移植肾周肿胀,查移植肾彩超发现移植肾上极血肿,肿块大小约8*7cm。行紧急盆腔CT检查,可见移植肾上级明显血肿。
查体 复查
CT检查提示移植肾上极血肿
诊断 治疗
诊断:移植肾周出血
治疗:复查患者血常规,发现血红蛋白为56g/L,申请4u红细胞输注。出血手术口放有引流管,未能引流出血液,暂保守治疗。
随访 处理
随访:患者术口引流管一直未能引流出血液,3天后拔出术口引流管。从术口引流管口流出较多陈旧性血液,每天都有,复查发现血肿体积明显减少。
讨论:肾移植术由于需要处理移植肾动、静脉,术后出血还是比较常见的并发症,非活动性出血尽量采取保守治疗。
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共4评论最早评论
- 曹欢易(暂停执业)回复李衡:像这种移植后出血功能还会恢复么?
![](https://pub-med-avatar.medlinker.com/15355987285woxl751.jpg)
李衡![](data:image/png;base64,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)
中山大学附属第三医院
出血灶在移植肾上极,吻合口周围是干净的,个人以为吻合口出血可能性不大。但是出血量还是很大的,血色素下降明显,患者有胸闷不适,输血治疗后改善。保守治疗也没再出血,...查看全部
2015-06-03 10:19
![](https://pub-med-avatar.medlinker.com/1535598749xaz6kmhh.jpg)
廖涛![](data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAACQAAAAkCAYAAAGWB6gOAAAAAXNSR0IArs4c6QAABCZJREFUWAm9WEtoFEEQfb3mI7mIgqIiBFTIxS8IIeslUdZ4EPEDevCigoK5qEE9il4EUYwgfkBP3jypIGIMooJJFBFFQRQRPQRyED8IfjaJ21Z1pz8z07Mzu0QHdrq66lV1dVd1dc8CgUcwT/Z3SCMT3cMiwWRhwSAgpimSkZbnm7BMQyTsFSy89Ejb4rdlGr1UphHENaw/cYGxmJxd+xVA0Nwe7zYY1eayFNHgjrzfOT3OdOvGAF7psfIv2b/6oA9MrJAvJAdviO6hzRFLUYDqLeK3CE69qx+43611CqKngcLZC1TOKM66IS24W9QtvUVp6OIU+CRkxZo0BE895KNdcQOMt06p0Cu6B/victOPGHJKRpzRFnBYlIZPMyprvatbqojVBmAN5fKGwzF/g9GlVm4y6SJUglH+eFJNcoAfbqSQloHO20DjDGDAOhCFC/HbrpG2PJkIBrZ4L7BwJ3BvLfAnORbDzOa3hpiZa3oMtI9ObO5SSnoPRQFuASmx5VJPOkmKG4rgJGts2p6Up3Bkf7FH3i2G55WiE2SHdnsIaMMfEqoAqIrganAIx7zIYvugUBRNhHycoa0hOdBxCBWcMoI8rW/YTc1FK4+NBMYZSohqY/iGVEGsTd2hlSG9sKHkc0C0HQBKgx4juhPosCv22GIbgXmdOZ1A6zZgaIfH1KTZVuyRrtg+pKUVWH5Cc1oWACuIfnkM+PHRR1mak1aF31i1kqZZVDpuAb8/AdNnAyM3gdcnrThK6BLs8si7QVggF7Lvb+lo3WVZUcLVcc9Q8TpXvCiwei+ckNV1MqUuj0KHWKa6A7jC1ti8HePla5B83+AnNE3xigTvlbggI0ll10gJY69oNN3CxmD5ulwd5UBxXxa6qkdZyixXg1TQR5VN0q+Xrx159NIwdTsUKqBukPqXM+gQbcEGTJQP0Jw7XDLY4VJOOyv3CC9ZDJezVWAYDc1nRdeDCcM2rctGw+FWZSW2aJb9FPAROWlVKaNHNZuTZHu83EHU1rght898id0iPnOK6ZQxwg5N8di1mEs4NHko1VQjkwNSai49DswtJUWW426elkWETerqu8ZXyaBb6fbWtl+Dfo0CT/YAY18ylNyunLwWj32jTGvO0NJiPih/jiShM5YAq84B08hMZRx4Rkf71+dJXBqHrtZ0F52pVkgXN3khDWv5q84Ds1bq7vc3wPMjevD2ywA7ys+7S8CHq5qu5U0fe/ZbzujlCluhCVhylPJjjVHT7adh4AU5KP9E+Zk9Fy6G2hzy9eii9JIsR+uHDzD0vPX0gbILeEr3qrHPhpuzFa/oY3pZHBwujPooznZo9A7Av/oefdzHdBPbPib/792wQ7FLyj/xKmWMYA5lOZAr+enfkWr/MKSNUZdDxljYsfocMTanpOUvhryfulkD/gWDhnKa1F1VfwAAAABJRU5ErkJggg==)
中山大学附属第三医院
出血止住了就没问题了,不会影响到移植肾功能,患者目前病情稳定。
2015-06-03 10:19
![](https://pub-med-avatar.medlinker.com/1535598749xaz6kmhh.jpg)
廖涛![](data:image/png;base64,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)
中山大学附属第三医院
是的,有没有可能是移植肾包膜有破裂?
2015-06-03 10:19
没有更多数据了