中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2012年
9期
544-547
,共4页
韩澍%张爱民%许龙根%郭义峰%周智华%陈怀周%李惊殊%金向阳
韓澍%張愛民%許龍根%郭義峰%週智華%陳懷週%李驚殊%金嚮暘
한주%장애민%허룡근%곽의봉%주지화%진부주%리량수%금향양
肾移植%儿童%治疗效果
腎移植%兒童%治療效果
신이식%인동%치료효과
Kidney transplantation%Child%Treatment outcome
目的 总结多个移植中心138例儿童肾移植的治疗效果.方法 回顾性分析8个移植中心自1986年3月至2010年5月间138例儿童肾移植的临床资料.受者年龄为(13.8±1.4)岁,其中男性92例,女性46例.138例均随访观察1年以上.初始免疫抑制方案均为以钙调磷酸酶抑制剂为主的三联方案,部分受者应用抗体诱导治疗.结果 术后1年受者和移植肾存活率分别为99.3％和95.7％.术后38例(27.5％)发生急性排斥反应,15例出现移植肾功能恢复延迟,但均在1个月内恢复.其他并发症为移植肾动脉狭窄8例,尿瘘5例,输尿管坏死2例,高血压57例,高脂血症38例,多毛症32例,药物性肝损伤26例,尿路感染25例,牙龈增生22例,肺部感染21例,骨髓抑制12例,单纯性疱疹10例,糖尿病8例.受者术后1年体重增加4～13 kg,身高增加2～7 cm.结论 细致地围手术期处理,免疫抑制剂的合理应用,加强随访,提高受者服药依从性是儿童肾移植获得良好效果的关键.
目的 總結多箇移植中心138例兒童腎移植的治療效果.方法 迴顧性分析8箇移植中心自1986年3月至2010年5月間138例兒童腎移植的臨床資料.受者年齡為(13.8±1.4)歲,其中男性92例,女性46例.138例均隨訪觀察1年以上.初始免疫抑製方案均為以鈣調燐痠酶抑製劑為主的三聯方案,部分受者應用抗體誘導治療.結果 術後1年受者和移植腎存活率分彆為99.3％和95.7％.術後38例(27.5％)髮生急性排斥反應,15例齣現移植腎功能恢複延遲,但均在1箇月內恢複.其他併髮癥為移植腎動脈狹窄8例,尿瘺5例,輸尿管壞死2例,高血壓57例,高脂血癥38例,多毛癥32例,藥物性肝損傷26例,尿路感染25例,牙齦增生22例,肺部感染21例,骨髓抑製12例,單純性皰疹10例,糖尿病8例.受者術後1年體重增加4～13 kg,身高增加2～7 cm.結論 細緻地圍手術期處理,免疫抑製劑的閤理應用,加彊隨訪,提高受者服藥依從性是兒童腎移植穫得良好效果的關鍵.
목적 총결다개이식중심138례인동신이식적치료효과.방법 회고성분석8개이식중심자1986년3월지2010년5월간138례인동신이식적림상자료.수자년령위(13.8±1.4)세,기중남성92례,녀성46례.138례균수방관찰1년이상.초시면역억제방안균위이개조린산매억제제위주적삼련방안,부분수자응용항체유도치료.결과 술후1년수자화이식신존활솔분별위99.3％화95.7％.술후38례(27.5％)발생급성배척반응,15례출현이식신공능회복연지,단균재1개월내회복.기타병발증위이식신동맥협착8례,뇨루5례,수뇨관배사2례,고혈압57례,고지혈증38례,다모증32례,약물성간손상26례,뇨로감염25례,아간증생22례,폐부감염21례,골수억제12례,단순성포진10례,당뇨병8례.수자술후1년체중증가4～13 kg,신고증가2～7 cm.결론 세치지위수술기처리,면역억제제적합리응용,가강수방,제고수자복약의종성시인동신이식획득량호효과적관건.
Objective To summary the clinical data of pediatric renal transplantation from multiple renal transplant centers in China,and analyze the factors influencing the therapeutic outcomes of pediatric renal transplantation.Methods From March 1986 to May 2010,the clinical data of 138 children who underwent renal transplantation in eight centers of renal transplantation in China were retrospectively analyzed.Results The one-year patient and graft survival rate was 99.3％ and 95.7％respectively.Acute rejection episodes occurred in 38 cases (27.5％),15 cases suffered delayed graft function (DGF),and graft functions were returned to normal in all recipients within one month.Moreover,other complications included transplant renal artery stenosis in 8 cases (5.8％),ureteral necrosis in 2 cases (1.4％),urinary fistula in 5 cases (3.6％),hypertension in 57 cases (41.3 ％),hyperlipidemia in 38 cases (27.5％),hirsutism in 32 cases (23.2％),drug-induced liver damage in 26 cases (18.8％),urinary tract infection in 25 cases (18.1％ ),gingival hyperplasia in 22 cases (15.9％),pulmonary infection in 21 cases (15.2％),bone marrow suppression in 12 patients (8.7％),herpes simplex in 10 cases (7.2％),and diabetes in 8 cases (5.8％).The body weight was increased by 4 to 13 kg and the body height was increased by 2 to 7 cm during the first year posttransplantation. Conclusion The careful perioperative management, rational use of immunosuppressive agents,strengthening the follow-up management of children and social support,and improving compliance were the key points to obtain good outcomes in pediatric renal transplantation.
