腹部多器官联合移植的围手术期处理  

Perioperative management of multiorgan transplantation

作　　者：于立新[1] 叶俊生[1] 邓文锋[1] 徐健[1] 付绍杰[1] 叶桂荣[1] 杜传福[1] 王亦斌[1] 刘小友[1] 苗芸[1] 

机构地区：[1]南方医科大学南方医院器官移植中心,广东广州510515

出　　处：《第一军医大学学报》2005年第2期165-167,共3页Journal of First Military Medical University

基　　金：全军医学科学技术研究"十五"计划基金重点课题项目(01Z049);广东省科技攻关项目(2KM05101S)

摘　　要：目的总结腹部多器官联合移植的围手术期处理经验。方法我院自2001年10月至2005年1月共施行19例腹部多器官联合移植术,其中胰肾联合移植6例、肝肾联合移植12例、肝胰联合移植1例;分析手术方法、免疫抑制剂的使用和术后并发症处理的方法。结果19例患者手术均获成功,术后发生FK506中毒1例(5.3%),发生急性排斥反应3例(15.8%),消化道出血发生2例(10.5%),腹腔出血1例(5.3%),肺部感染1例(5.3%),经相应治疗后好转。结论腹部多器官联合移植成功的关键是作好供体选择、保证供器官质量、选择适当手术方式、术后合理应用免疫抑制剂以及有效防治术后并发症。Objective To summarize the experience with perioperative management of multiorgan transplantation. Methods From October 2001 to January 2005, 19 patients received multiorgan transplantation in Nanfang Hospital, including 6 with simultaneous kidney-pancreas transplantation (SKPT), 12 with combined liver-kidney transplantation (CLKT), and 1 with simultaneous liver-pancreas transplantation (SLPT). The surgical techniques, application of immunosuppressants, and complication management were reviewed. Results All transplantation procedures were performed successfully. The transplantation-related complications included tacrolimus-induced renal toxicosis in 1 (5.3%) case, acute graft rejection in 3 (15.8%) cases, intestinal hemorrhage in 2 (10.5%) cases, intra-abdominal hemorrhage in 1 (5.3%) case, and lung infection in 1 (5.3%) case, all of which were cured after proper treatment. Conclusions Donor selection, good quality of the donor organ, proper surgical approaches, adequate use of the-mmunosuppressants, and prevention of complications are essential to the success of multiorgan transplantation.

关 键 词：联合移植 围手术期 肝脏移植 肾脏移植 胰腺移植 

分 类 号：R617[医药卫生—外科学]