胰液空肠引流式全胰十二指肠肾一期联合移植(病例报告及文献复习)  

Modified simultaneous kidney-pancreatico-duodenal transplantation with jejunum drainage of exocrine pancreatic secretions: a case repert and literature review

作　　者：徐友和[1] 明长生[2] 李香铁[1] 李慎勤[1] 张爱民[1] 李明杰[1] 刘仰东[1] 刘少鸽[1] 孙文杰[1] 

机构地区：[1]济南军区总医院泌尿科,山东济南250031 [2]华中科技大学附属同济医院,湖北武汉430014

出　　处：《实用医药杂志》2005年第2期99-101,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的总结胰液空肠引流改良术式胰、肾联合移植的临床体会。方法对1例胰岛素依赖型糖尿病并发尿毒症患者施行胰液空肠引流改良术式全胰、十二指肠及肾一期联合移植。术后早期采用皮质激素、霉酚酸酯(MMF)、他克莫司(FK506)和环磷酰胺进行免疫治疗,维持免疫抑制采用FK506和MMF二联方案。结果术后第5天移植肾、胰功能恢复良好,血肌酐、尿素氮和空腹血糖降至正常,第24天完全停用胰岛素;术后第6天FK506浓度过高致肾中毒、第9天细菌培养阳性和第19天并发消化道出血,均经相应治疗痊愈。结论胰液空肠引流改良术式全胰、十二指肠及肾联合移植是治疗胰岛素依赖型糖尿病并发尿毒症的有效方法,优于胰液膀胱引流术式。Objective To sum up the clinical experience of using the modified technique of simultaneous kidney-pancreatic transplantation (SKPT) with jejunum drainage(JD).Methods The modified JD-SKPT without Roux-en-y was performed on a patient with insulin-dependent diabetic mellitus (IDDM) and uremia. After operation, the patient received an immunosuppression therapy including pred-nisone,Mycophenolate-Mofetil(MMF),FK506 and cyclophosphamide. Results The renal and pancreatic graft obtained normal function and serum creatinine and fasting blood glucose were decreased to normal levels later 5 days after transplantation. The patient became insulin-independent after he had been treated by small dose insulin for 24 days.Conclusion The modified JD-SKPT is a more effective therapy for treating IDDM with uremia than BD-SKPT (simultaneous kidney-pancreatic transplantation with bladde drainage). [

关 键 词：胰 肾 移植 尿毒症 糖尿病 胰岛素依赖型 

分 类 号：R617[医药卫生—外科学]