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胰十二指肠及肾一期联合移植5例报告

Simultaneous kidney pancreaticoduodenal transplantation:report of 5 cases

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【作者】 郑树森陈江华金炜张珉梁廷波王伟林朱琮王逸民徐红朱伟芳

【Author】 ZHENG Shusen, CHEN Jianghua, JIN Wei, et al. First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou 310003

【机构】 浙江医科大学附属第一医院普外科

【摘要】 目的开展和进一步总结胰肾一期联合移植术的经验。方法回顾性总结4年来共实行胰十二指肠肾脏一期联合移植术5例的方法、疗效及并发症的预防和治疗。结果本组5例于术后移植胰腺和移植肾均发挥了正常功能,术后第1~10天均停用胰岛素,空腹血糖在正常范围。术后并发症常见,计本组出现的并发症为胰周感染或脓肿3例,十二指肠残端瘘1例,化学性或细菌性膀胱炎4例,移植胰巨细胞病毒(CMV)感染1例,代谢性酸中毒2例,肺部感染2例和急性排斥反应1例。并发症经处理后大多都能得到控制。本组中有2例已分别存活4年6个月和3年5个月,1例术后3周死于移植肾急性排斥反应多器官功能衰竭。结论胰十二指肠肾脏一期联合移植对治疗Ⅰ型糖尿病并发晚期尿毒症具有肯定的临床疗效,较其它移植有许多优点。术后并发症的预防和正确治疗是影响病人长期存活的重要因素

【Abstract】 Objective To sum up the preliminary experience of simultaneous kidney pancreaticoduodenal transplantation (SKPT) performed in 5 cases.Methods From Apr. 1994 to Apr. 1998, five cases in end stage of type I diabetes mellitus received SKPT. Results The functions of pancreas and kidney grafts were normal in all patients during 1~10 days postoperation. Complications included peripancreatic infection or abscess, duodenal remnant fistulae, chemical or bacterial cystitis. CMV infection of pancreas graft, metabolic acidosis, pneumonia and acute rejection were not uncommon.Two cases are alive and well with graft function for four years six months and three years five months postoperation,respectively. Conclusions SKPT is a effective therapy for the treatment of end stage type Ⅰ diabetes mellitus complicated by uremia. Prevention and correct treatment of postoperative complications is a key to long term results of recipients.

  • 【文献出处】 中华普通外科杂志 ,CHINESE JOURNAL OF GENERAL SURGERY , 编辑部邮箱 ,1999年02期
  • 【分类号】R617
  • 【被引频次】6
  • 【下载频次】32
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