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

作　　者：郑树森[1] 陈江华[1] 金炜[1] 张珉[1] 梁廷波[1] 王伟林[1] 朱琮[1] 王逸民[1] 徐红[1] 朱伟芳[1] 

机构地区：[1]浙江医科大学附属第一医院普外科

出　　处：《中华普通外科杂志》1999年第2期85-88,共4页Chinese Journal of General Surgery

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。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.

关 键 词：糖尿病 并发症 尿毒症 胰腺 肾 联合移植 

分 类 号：R617[医药卫生—外科学]