论文部分内容阅读
目的:探讨2型糖尿病肾病尿毒症期行胰肾联合移植术后存活期超过15年受者生活质量及器官功能状态。方法:回顾分析中国医科大学附属第一医院2000年至2005年因2型糖尿病肾病尿毒症期行胰肾联合移植术后随访至今(2017年失访1例)存活期超过15年的4例受者的资料，评估移植胰腺、移植肾功能，对生活质量及并发症进行分析。结果:4例受者原发病均为2型糖尿病肾病。手术方式均为同期胰肾联合移植(膀胱引流式)。受者在随访过程中生活质量良好。4例受者中3例肾功能和空腹血糖、C肽检查均正常，1例血清肌酐和空腹血糖轻度升高。1例术后15年发生淋巴瘤，1例术后14年出现切口疝行疝修补术。1例术后出现3次血尿。结论:2型糖尿病肾病尿毒症期行胰肾联合移植术，移植胰腺及肾功能稳定，术后因免疫抑制引起的恶性肿瘤仍然需密切注意。“,”Objective:To explore the long-term outcomes of patients with type 2 diabetes mellitus(T2DM)and end-stage renal disease(ESRD)after simultaneous pancreas kidney(SPK)transplantation.Methods:The clinical data were analyzed retrospectively for 4 patients with T2DM and ESRD surviving over 15 years after SPK transplantation.Results:All of them survived for over 15 years. Transplantation was performed with a standard approach via a drainage of exocrine secretion into bladder and a diversion of venous outflow into systemic circulation. During a follow-up period of over 15 years, blood glucose, C-peptide and serum creatinine levels of 3/4 patients remained normal and stable. Serum creatinine and blood glucose slightly increased in 1 patient at 11 years post-SPK. One patient had lymphoma at 15 years after operation. Incisional hernia occurred at 14 years after operation in 1 patient and hernioplasty was performed. One patient had the symptoms of multiple hematuria.Conclusions:SPK transplantation can achieve a stable long-term efficacy over 15 years in patients with T2DM and ESRD. Postoperative malignant tumors require close monitoring.