中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2009年
1期
34-36
,共3页
肾移植%肿瘤%治疗
腎移植%腫瘤%治療
신이식%종류%치료
Kidney transplantation%Neoplasms%Therapy
目的 总结肾移植后并发恶性肿瘤的治疗体会.方法 同顾分析1812例肾移植后接受免疫抑制治疗6个月以上患者的资料.1812例中,58例发牛恶性肿瘤.患者发生恶性肿瘤时的年龄为31～67岁,平均为45岁,诊断时间为移植术后18～220个月,平均为98个月.58例中,44例经病理检查证实为恶性肿瘤,其中泌尿系统肿瘤19例,消化系统肿瘤14例,血液系统肿瘤5例,其他6例;6例临床诊断为恶性肿瘤,但未经病理证实;8例资料不全,不参与结果 统计.50例参与统计的患者接受以外科手术为主的综合治疗,其中10例停用免疫抑制剂,其余40例的免疫抑制剂用量减少1/3～1/2.结果 50例诊断肿瘤后的1年存活率为68.0%,其中19例泌尿系统肿瘤患者的1年存活率为73.7%,14例消化系统肿瘤患者的1年存活率为42.9%.同前存活的26例中,移植肾仍有功能者20例,维持性血液透析者2例,腹膜透析者4例.结论 完善的随访制度有利于肾移植后恶性肿瘤的早期诊断,此类患者的治疗以手术治疗为主,同时应合理减少免疫抑制剂的用量,并调整用药方案.
目的 總結腎移植後併髮噁性腫瘤的治療體會.方法 同顧分析1812例腎移植後接受免疫抑製治療6箇月以上患者的資料.1812例中,58例髮牛噁性腫瘤.患者髮生噁性腫瘤時的年齡為31～67歲,平均為45歲,診斷時間為移植術後18～220箇月,平均為98箇月.58例中,44例經病理檢查證實為噁性腫瘤,其中泌尿繫統腫瘤19例,消化繫統腫瘤14例,血液繫統腫瘤5例,其他6例;6例臨床診斷為噁性腫瘤,但未經病理證實;8例資料不全,不參與結果 統計.50例參與統計的患者接受以外科手術為主的綜閤治療,其中10例停用免疫抑製劑,其餘40例的免疫抑製劑用量減少1/3～1/2.結果 50例診斷腫瘤後的1年存活率為68.0%,其中19例泌尿繫統腫瘤患者的1年存活率為73.7%,14例消化繫統腫瘤患者的1年存活率為42.9%.同前存活的26例中,移植腎仍有功能者20例,維持性血液透析者2例,腹膜透析者4例.結論 完善的隨訪製度有利于腎移植後噁性腫瘤的早期診斷,此類患者的治療以手術治療為主,同時應閤理減少免疫抑製劑的用量,併調整用藥方案.
목적 총결신이식후병발악성종류적치료체회.방법 동고분석1812례신이식후접수면역억제치료6개월이상환자적자료.1812례중,58례발우악성종류.환자발생악성종류시적년령위31～67세,평균위45세,진단시간위이식술후18～220개월,평균위98개월.58례중,44례경병리검사증실위악성종류,기중비뇨계통종류19례,소화계통종류14례,혈액계통종류5례,기타6례;6례림상진단위악성종류,단미경병리증실;8례자료불전,불삼여결과 통계.50례삼여통계적환자접수이외과수술위주적종합치료,기중10례정용면역억제제,기여40례적면역억제제용량감소1/3～1/2.결과 50례진단종류후적1년존활솔위68.0%,기중19례비뇨계통종류환자적1년존활솔위73.7%,14례소화계통종류환자적1년존활솔위42.9%.동전존활적26례중,이식신잉유공능자20례,유지성혈액투석자2례,복막투석자4례.결론 완선적수방제도유리우신이식후악성종류적조기진단,차류환자적치료이수술치료위주,동시응합리감소면역억제제적용량,병조정용약방안.
Objective To summarize the clinical experience in treatment of malignant tumors of renal allograft recipients. Methods A retrospective study was performed on renal allograft recipients who received immunosuppressive treatment at least half a year between 1978 and 2005. Results Fifty-eight cases of tumors were found in 1812 cases undergoing renal transplantation, 50 cases of them who had complete clinical data were included into analysis. Forty-four cases, that included 19 cases in rological system, 14 cases in digestive system, 5 cases in blood system, 6 cases in other systems, were diagnosed as having malignant tumors by pathological analysis. Most of them were treated with surgery. One-year survival rate was 68.0% after the diagnosis of malignant tumor. The longest survival time was 6.5 years. Most of the survivals possessed normal function of allograft. Conclusion Systemic follow-up is important for renal allograft recipients who suffered malignant tumors. Surgical operation is still the main therapy for those solid tumors. It is critical for the therapy of malignancies and quality of life to possess satisfactory allograft function. The strategy of treatment should take consideration of the relationship between the decrease dose of immunosuppressive agents and the preservation of allograft function.
