胰肾联合移植早期治疗临床研究

Analysis of the early results of one simultaneous pancreas-kidney transplantation

目的探讨胰肾联合移植术后治疗措施。方法1例胰肾联合移植术后给以免疫抑制、小剂量肝素化和胰岛素替代治疗,监测移植胰、肾功能及并发症情况。结果胰腺功能恢复顺利,1个月后脱离胰岛素,血糖维持正常;移植肾功能1周恢复正常,随后出现排斥反应,相应治疗后改善;术后3周出现下消化道出血。结论胰肾联合移植是针对IDDM合并终末期肾病的有效治疗措施。早期胰岛素替代治疗有利于移植胰功能的逐渐恢复。早期小剂量肝素化,有利于减少移植胰血栓形成的几率。

Objective To explore the treatments after simultaneous pancreas-kidney transplantation（SPK）.Methods Immunosuppression,heparinization and replacement of insulin were applicated after SPK.Results The pancreatic function recovered successfully.Blood sugar maintained normal one month after operation insulin-independent.A week after operation,the function of transplanted kidney recovered smoothly,but occurred acute rejection episode subsequently.The acute rejection recoveried after correspondent treatment.The lower digestive tract hemorrhage happed 3 weeks after operation.Conclusion SPK is an operative treatments to patients with insulin-dependent diabetes mellitus and end-stage renal disease.Early treatment by insulin is favor of the recovery of the pancreatic function.The early treatment of heparinization can decrease thrombosis of transplanted pancreas.