胰腺十二指肠肾脏一期联合移植五例报告

Simultaneous pancreas-kidney transplantation:a report of 5 cases

目的探讨胰腺十二指肠肾脏一期联合移植治疗Ⅰ型糖尿病伴肾功能衰竭的治疗途径。方法对我院开展的5例胰、肾一期联合移植病人进行回顾性分析。结果 5例病人中,3例术后胰腺及肾脏功能良好,未使用胰岛素,进正常饮食,血糖一直在正常范围,至今已分别生存20,14,11个月。其余2例病人中,1例术后第47 d 死于急性心功能衰竭,另1例因血栓形成,于术后33 d 切除移植的胰腺,但肾功能良好。结论胰、肾联合移植是治疗Ⅰ型糖尿病伴肾功能衰竭的有效方法之一,术后通常根据血糖、尿糖、尿淀粉酶、C 肽及尿细胞学检查等指标改变,判断移植后胰腺及肾脏的功能情况。

Objective To explore methods for treatment of type Ⅰ diabetes complicated with end- stage renal failure.Methods Clinical data of 5 cases receiving simultaneous pancreas-kidney trans- plantation in our hospital were retrospectively analyzed.Results Pancreatic and renal grafts recovered normal functions in 3 patients.The 3 patients became insulin-independent and had normal renal func- tion.Meanwhile,their diet was normal again while level of blood sugar remained normal.From then on,they have survived for 20,14 and 11 months,respectively.As for the other 2 patients,1 died of acute cardiac failure on postoperative day 47 and 1 had the pancreatic graft resected on day 33 postop- eratively because of thrombosis.However,renal function was normal in these 2 patients.Conclusions Simultaneous pancreas-kidney transplantation is one the better techniques for treatment of type Ⅰ di- abetes complicated with end-stage renal failure.After the operation,it is necessary to determine the functional conditions of the pancreatic and renal grafts through detecting the changes in blood sugar, uric sugar,uric amylase,C peptide and uric cytology.