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作 者:陈仕平[1] 林震[1] 陈文华[1] 叶传忠[1] 郑松[1] 翁明高[1]
机构地区:[1]福建医科大学附属协和医院泌尿外科,福建福州350001
出 处:《中国医师杂志》2002年第9期963-965,共3页Journal of Chinese Physician
摘 要:目的 为探讨胰肾联合移植 (SPKT)的最佳术式和提高手术操作技巧 ,利用试验动物进行胰肾联合移植。方法 在 12只试验用狗上分别进行胰、部分十二指肠、肾、输尿管多器官联合切取后行脾动、静脉分别与肾功、静脉行端端吻合 ,使胰、肾联成整体。将移植物的腹腔动脉与受体右髂总动脉行端端吻合 ,移植物的门静脉与受体右髂总静脉行端侧吻合 ,供体十二指肠远端与受体膀胱右顶部行端侧吻合 ,供体输尿管与受体膀胱左侧壁吻合 ,供胰、十二指肠固定于受体右髂窝 ,供肾固定于左髂窝。结果 6只供体顺利完成多器官联合切取术及胰肾联体血管吻合术 ;6只受体顺利完成胰肾联合移植术 ,术后 1只死于持续性低血压 ,5只术后平均存活 (1 5±0 8)d ,存活中期胰肾功能基本正常。结论 该术式手术时间短 ,受体创伤小 ,胰腺外分泌引流入膀胱 ,可通过检测淀粉酶发现早期排斥反应 。Objective To explore a best operative method in order to improve operative manipulated skill of simultaneous pancreas-kidney transplantation(SPKT),a model of SPKT was established in dogs.Methods 12 dogs of SPKT were performed in animal model.A renoportal end-to-end anastomoses between the renal and the spleen vein.Only two vascular end-to-side anastomoses between the donor portal vein and recipient ilio-vein,and between the donor celiac arteries and recipient abdominal aorta were constructed.Pancrease was placed in the right iliac fossa and kidney in the left.Pancreatic exocretion goes through bladder drainage.Results Combined resection was successfully performed in 6 dogs and the other underwent simultaneous pancreas-kidney transplantation.Satisfactory result was obtained in 5 survival dog for a mean of (1 5±0 8)days,although 1 dog died from hypopiesis.Conclusions The model is practically feasible and might be used in studying the problems involved in SPKT,which is effective for the treatment of end-stage diabetic nephropathy.
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