改良的胰液空肠引流式胰、肾一期联合移植(附2例报道)  

Modified simultaneous kidney-pancreaticoduodenal transplantation with enteric drainage of exocrine pancreatic secretions: 2 cases report

作　　者：明长生[1] 沙波[1] 曾凡军[1] 陈知水[1] 文志向[1] 张伟杰[1] 林正斌[1] 陈忠华 夏穗生[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院器官移植研究所,武汉430030

出　　处：《中华器官移植杂志》2001年第4期218-220,共3页Chinese Journal of Organ Transplantation

摘　　要：目的　报告 2例改良的胰液空肠引流式胰、十二指肠及肾联合移植的外科技术和治疗胰岛素依赖型糖尿病并发尿毒症的效果。方法　 2 0 0 0年 6～ 9月 ,2例胰岛素依赖型糖尿病并发尿毒症的患者接受胰、十二指肠及肾一期联合移植 ,移植胰的外分泌采用空肠内引流 ,不作Roux en Y型吻合。结果　移植后 ,立即停用胰岛素 ,肾功能 1～ 5d恢复正常 ,无外科并发症 ,未发生排斥反应 ,患者目前已分别存活 5个月和 2个月 ,移植胰和移植肾功能均正常 ,一般情况良好。结论　改良的胰液空肠引流式胰、十二指肠及肾联合移植技术简单、安全 ,是治疗Ⅰ型糖尿病并发尿毒症的较好术式。Objectives To report the modified technique and the results of simultaneous kidney-pancreaticoduodenal transplantation (SKPT) with the enteric drainage (ED) of exocrine secretions in the treatment of 2 cases of insulin-dependent diabetic mellitus (IDDM) associated with uremia.Methods From June to Sep. of 2000, 2 cases of IDDM with uremia underwent SKPT. The allograft exocrine secretions were drained into the proximal jejunum via a side-to-side duodenojujunostomy (no Roux-en-Y).Results ED-SKPT without Roux-en-Y was successful in the 2 patients without any complications. The two patients became immediately insulin-independent postoperatively. Until now the grafts of pancreas and kidney functioned well. No rejection occurred.Conclusion The modified ED-SKPT without Roux-en-Y is a simple, safe and effective therapy for treatment of IDDM with uremia.

关 键 词：胰岛素依赖型糖尿病 联合移植 胰腺移植 肾移植 

分 类 号：R657.5[医药卫生—外科学] R699.2[医药卫生—临床医学]