肾移植术治疗糖尿病尿毒症13例报告

Clinical analysis of kidney transplantation for the uremic patients with non-insulin-dependent diabetes mellitus (NIDDM): Report of 13 cases

总结对13例Ⅱ型糖尿病尿毒症患者行肾移植术的体会:①糖尿病患者移植术前应将病情控制使之稳定;②术后合理应用胰岛素;③警惕高渗性非酮症糖尿病昏迷;④对高龄尿毒症病人术前应注意糖尿病的诊断;⑤防治心血管并发症;⑥重视感染的防治。并结合文献复习,就糖尿病对肾脏的主要病理损害和免疫抑制药对糖代谢的影响及肾脏替代疗法的疗效等进行讨论。

13 uremic patients with non-insulin-dependent diabetes mellitus (NIDDM)received kidney transplantation from Jan. 1991 tojul. 1992, and the clinical results were analysed here. We discussed the diabetic glomerulosclerosis, renal replacement therapy for diabetic end stage renal failure and the affection of carbohydrate metabolism of glucocorticoid and cyclosporine A. We suggestedthat: ① the condition of the uremic patients with NIDDM must bewell controled before transplantation; ② insuline ther apy should be taken postopretively;③hyperosmotic nonketonic diabetic coma (HNDC) should be taken in mind after transplantation for the high risk patients;④ attention must be paid to diagnosis of NIDDM for the aging patients with uremia before transplantaion and ⑤ prevention and treatment of cardiovascular complication and ; ⑥ of infection.