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目的 总结膀胱引流术式胰、肾联合移植经验和教训。方法 对 2例胰岛素依赖型糖尿病并发尿毒症患者施行膀胱引流式胰、肾联合移植 ,术后早期采用皮质激素、霉酚酸酯 (MMF)、环孢素A(CsA) /他克莫司 (FK5 0 6 )和抗淋巴细胞球蛋白 (ALG)进行免疫抑制治疗 ,8～ 10d后改为FK5 0 6、MMF和泼尼松维持。结果 移植后 ,2例均立即停用胰岛素 ,肾功能逐渐恢复正常 ,仅例 2术后并发轻微切口感染 ,经引流、局部处理后愈合 ,无其它外科并发症 ,未发生排斥反应 ,患者目前已分别存活 6个月和 2个月 ,移植胰和移植肾功能均正常 ,一般情况良好。结论 膀胱引流式胰、肾联合移植术是治疗胰岛素依赖型糖尿病并发尿毒症的有效方法
Objective To summarize the experiences and lessons of combined drainage of pancreas and kidney with bladder drainage. Methods Two patients with uremia complicated with insulin-dependent diabetes mellitus underwent bladder drainage combined with pancreas and kidney transplantation. The patients were treated with corticosteroid, mycophenolate mofetil (MMF), cyclosporin A (CsA) / tacrolimus FK506) and anti-lymphocyte globulin (ALG) for immunosuppressive therapy, after 8 ~ 10d changed to FK506, MMF and prednisone maintenance. Results After the transplantation, insulin was stopped in both of the 2 patients and the renal function gradually returned to normal. Only 2 cases were complicated with slight incision infection after operation. After drainage and local treatment, there was no other surgical complications and no rejection occurred. Respectively survive 6 months and 2 months, the function of grafted pancreas and graft kidney are normal, generally good. Conclusions Bladder drainage pancreatic and renal transplantation is an effective method for the treatment of uremia with insulin-dependent diabetes mellitus