中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2014年
12期
724-727
,共4页
郑建明%宋文利%涂金鹏%莫春柏%沈中阳
鄭建明%宋文利%塗金鵬%莫春柏%瀋中暘
정건명%송문리%도금붕%막춘백%침중양
肾移植%胰腺移植%联合移植%外科并发症%糖尿病%外科治疗
腎移植%胰腺移植%聯閤移植%外科併髮癥%糖尿病%外科治療
신이식%이선이식%연합이식%외과병발증%당뇨병%외과치료
Kidney transplantation%Pancreas transplantation%Combined transplantation%Surgical complication%Diabetes%Surgical treatment
目的 分析胰肾联合移植后并发症外科治疗的原因及预后.方法 回顾性分析了1999年12月至2012年6月单中心实施胰肾联合移植70例的临床资料,对受者术后因并发症而行外科治疗的原因及结果进行分析.结果 胰肾联合移植后因并发症而行外科治疗者有16例,占总例数的22.9％,其中4例接受多次手术.再手术原因主要包括血尿(2例)、腹腔出血(4例)、腹腔感染(4例)、胰腺血栓形成(4例)、移植肾动脉破裂(2例)、移植肾破裂(1例)、吻合口漏(1例)及胰瘘(1例).1年内胰腺功能丧失8例,3例为移植器官带功能受者死亡,另5例均为术后移植胰腺切除,原因分别为胰腺血栓形成4例,肠瘘1例,占再手术患者的43.8％.再手术者的受者、移植肾、移植胰腺1年存活率为87.5％、75.0％和56.3％.未接受手术者54例,受者、移植肾、移植胰腺1年存活率为98.1％、98.1％和98.1％.两组比较,受者存活率的差异无统计学意义(P＞0.05,x2=1.31),移植肾存活率的差异有统计学意义(P＜0.01,x2=6.79),移植胰腺存活率的差异有统计学意义(P＜0.01,x2=17.47).结论 胰肾联合移植为糖尿病合并终末期肾病提供了成功、有效的临床治疗手段,术后出现因并发症而需外科治疗会显著降低胰肾联合移植术后移植物的短期存活.
目的 分析胰腎聯閤移植後併髮癥外科治療的原因及預後.方法 迴顧性分析瞭1999年12月至2012年6月單中心實施胰腎聯閤移植70例的臨床資料,對受者術後因併髮癥而行外科治療的原因及結果進行分析.結果 胰腎聯閤移植後因併髮癥而行外科治療者有16例,佔總例數的22.9％,其中4例接受多次手術.再手術原因主要包括血尿(2例)、腹腔齣血(4例)、腹腔感染(4例)、胰腺血栓形成(4例)、移植腎動脈破裂(2例)、移植腎破裂(1例)、吻閤口漏(1例)及胰瘺(1例).1年內胰腺功能喪失8例,3例為移植器官帶功能受者死亡,另5例均為術後移植胰腺切除,原因分彆為胰腺血栓形成4例,腸瘺1例,佔再手術患者的43.8％.再手術者的受者、移植腎、移植胰腺1年存活率為87.5％、75.0％和56.3％.未接受手術者54例,受者、移植腎、移植胰腺1年存活率為98.1％、98.1％和98.1％.兩組比較,受者存活率的差異無統計學意義(P＞0.05,x2=1.31),移植腎存活率的差異有統計學意義(P＜0.01,x2=6.79),移植胰腺存活率的差異有統計學意義(P＜0.01,x2=17.47).結論 胰腎聯閤移植為糖尿病閤併終末期腎病提供瞭成功、有效的臨床治療手段,術後齣現因併髮癥而需外科治療會顯著降低胰腎聯閤移植術後移植物的短期存活.
목적 분석이신연합이식후병발증외과치료적원인급예후.방법 회고성분석료1999년12월지2012년6월단중심실시이신연합이식70례적림상자료,대수자술후인병발증이행외과치료적원인급결과진행분석.결과 이신연합이식후인병발증이행외과치료자유16례,점총례수적22.9％,기중4례접수다차수술.재수술원인주요포괄혈뇨(2례)、복강출혈(4례)、복강감염(4례)、이선혈전형성(4례)、이식신동맥파렬(2례)、이식신파렬(1례)、문합구루(1례)급이루(1례).1년내이선공능상실8례,3례위이식기관대공능수자사망,령5례균위술후이식이선절제,원인분별위이선혈전형성4례,장루1례,점재수술환자적43.8％.재수술자적수자、이식신、이식이선1년존활솔위87.5％、75.0％화56.3％.미접수수술자54례,수자、이식신、이식이선1년존활솔위98.1％、98.1％화98.1％.량조비교,수자존활솔적차이무통계학의의(P＞0.05,x2=1.31),이식신존활솔적차이유통계학의의(P＜0.01,x2=6.79),이식이선존활솔적차이유통계학의의(P＜0.01,x2=17.47).결론 이신연합이식위당뇨병합병종말기신병제공료성공、유효적림상치료수단,술후출현인병발증이수외과치료회현저강저이신연합이식술후이식물적단기존활.
Objective To analyze the complications,treatments and prognosis of simultaneous pancreas-kidney transplantation,especially on surgical complications and treatments.Method The causes and outcomes of surgical treatment in 70 cases of simultaneous pancreas-kidney transplantation performed between Dec.1999 and June 2012 were retrospectively analyzed in our center.Result Sixteen patients (22.9％) underwent one or more reoperations.The causes for reoperation were as follows:2 cases of hematuria,4 cases of abdominal hemorrhage,4 cases of abdominal infection,4cases of pancreatic thrombosis,2 cases of renal graft's artery rupture,1 case of renal allograft rupture,1 case of intestinal fistula,and 1 case of pancreatic fistula.Eight pancreas grafts were lost in the first year.Pancreatectomy was performed on the other 5 cases:4 cases of pancreatic thrombosis,1 case of intestinal fistula,accounting for 43.8％ of the patients subject to reoperation.The recipients,kidney,pancreas survival rate in reoperation group at 1 year was 87.5％,75％,and 56.3％ respectively; and that in control group at 1 year was 98.1％,98.1 ％,and 98.1 ％ respectively.There was significant difference in kidney survival rate (P＜0.01,chi-square =6.79),and pancreas survival rate (P＜0.01,chi-square =17.47) between two groups.Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with end-stage renal disease,surgical treatment due to complications is still an important factor in short-term survival on the grafts.
