临床同种活体部分小肠移植:附1例报告  

Clinical living-related segmental small bowel transplantation: a case report

作　　者：王曙逢[1] 车向明[1] 陈进才[1] 禄韶英[1] 霍雄伟[1] 樊林[1] 李国威[2] 

机构地区：[1]西安交通大学医学院第一附属医院普通外科 [2]西安交通大学医学院第二附属医院普通外科,陕西西安710061

出　　处：《中国普通外科杂志》2005年第12期931-933,共3页China Journal of General Surgery

摘　　要：目的探讨临床同种活体小肠移植治疗短肠综合征的效果。方法对1例因小肠扭转而切除大部分小肠和右半结肠,残留小肠仅2 0 cm的超短肠综合征男性患者,行亲属活体同种部分小肠移植。供体为患者之母。受体术前行供体特异性输血,5 0mL/周,共8周。供受体巨细胞病毒感染状态均为阴性。移植肠长约1 6 0 cm。移植肠的回结肠动静脉分别与受体肾下腹主动脉和下腔静脉端侧吻合,移植肠末端造口。术后给予抗排斥、抗感染、抗凝及营养支持治疗。结果供体术后恢复顺利,无并发症。受体已健康存活3 1周,无感染和排斥反应。术后8周脱离肠外营养治疗,口服低脂饮食,D-木糖吸收试验结果接近正常。结论同种活体部分小肠移植是治疗短肠综合征的有效措施。Objective To investigate the effect of short bowel syndrome treated with living-related small bowel transplantation （SBT） . Methods A male patient with residual intestine 20 cm in length, which resulted from subtotal small bowel resection and right hemi-colectomy owing to intestinal volvulus, received a living-related SBT. The donor was the patient＇s mother. Donor specific blood transfusion, 50mL/per week, was carried out for 8 weeks. Cytomegalovirus infection status in both donor and recipient was negative. A 160cm segment of intestine was transplanted. The graft ileocolic artery and vein was anastomosed to the recipient＇s infrarenal aorta and inferior vena cava end - to - side, respectively. A distal ileostomy was performed. Immunosuppression, anti-infection and anticoagulation therapy, and nutritional support were given postoperatively. Results The donor had an uneventful recovery. No technical complications were observed. The recipient was alive and well 31 weeks after operation. No graft rejection or infection was found. The patient was taken off TPN 8 weeks after operation, and got a low-fat meal. The result of D-xylose test was near normal. Conclusions Living-related small intestine transplantation is an effective treatment for short bowel syndrome.

关 键 词：移植 同种 小肠/移植 活体供者 短肠综合征 

分 类 号：R617[医药卫生—外科学] R656.7[医药卫生—临床医学]