• 四川大學(xué)華西醫(yī)院普通外科（成都610041）;

目的 　研究豬胰十二指腸移植治療實(shí)驗(yàn)性Ⅰ型糖尿病的可行性及其意義。
方法 　選四川當(dāng)?shù)仉s種長(zhǎng)白豬46頭（體重25~32 kg），分為供、受體2組(n=23)，進(jìn)行同種異體胰十二指腸移植手術(shù)。觀察術(shù)后手術(shù)并發(fā)癥，術(shù)前、術(shù)中及術(shù)后1、3、5及7 d檢測(cè)血糖、胰島素及胰高血糖素水平，觀察移植物存活及急性排斥反應(yīng)情況。
結(jié)果 　進(jìn)行豬同種異體胰十二指腸移植23例，手術(shù)中因麻醉意外死亡1例，手術(shù)成功率為95.7%。發(fā)生手術(shù)并發(fā)癥2例，其中靜脈血栓形成1例（4.5%），十二指腸空腸吻合口漏1例（4.5%）。在切除胰腺30 min內(nèi)即可見(jiàn)血糖升高，術(shù)后第3 d開始恢復(fù)至術(shù)前水平。胰島素和胰高血糖素在切除胰腺30 min內(nèi)開始下降，術(shù)后第3 d開始恢復(fù)到術(shù)前水平。手術(shù)后第1 d開始出現(xiàn)排斥反應(yīng)，并逐漸加重，第9 d達(dá)到高峰，但未出現(xiàn)血糖、胰島素及胰高血糖素水平變化和排斥反應(yīng)的臨床癥狀。
結(jié)論 　豬胰十二指腸移植治療Ⅰ型糖尿病效果確實(shí)、可靠，移植術(shù)后急性排斥反應(yīng)是影響術(shù)后功能的主要因素。

引用本文： 胡偉明,韓方海,張肇達(dá),周詳,孟令祥. 豬同種異體胰十二指腸移植門靜脈回流腸內(nèi)引流模型的實(shí)驗(yàn)研究. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007, 14(2): 171-176. doi: 復(fù)制

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  1. 1. 　Weir GC, Bonner-Weir S. Scientific and political impediments to successful islet transplantation [Ｊ]. Diabetes, 1997; 46(8)∶1247.
  2. 2. 　West M, Gruessner AC, Metrakos P, et al. Conversion from bladder to enteric drainage after pancreaticoduodenal transplantations [Ｊ]. Surgery, 1998; 124(5)∶ 883.
  3. 3. 　Gaber AO, Shokouh-Amiri MH, Hathaway DK, et al. Results of pancreas transplantation with portal venous and enteric drainage [Ｊ]. Ann Surg, 1995; 221(6)∶ 613.
  4. 4. 　陳實(shí)， 馮變喜， 陳剛， 等. 胰液腸內(nèi)引流式胰腎同時(shí)聯(lián)合移植(附一例報(bào)告) [Ｊ]. 中華器官移植雜志, 2000; 21(1)∶ 52.
  5. 5. 　于立新, 明長(zhǎng)生, 鄧文峰, 等. 胰液腸腔引流式胰十二指腸及腎一期聯(lián)合移植一例報(bào)告 [Ｊ]. 中華器官移植雜志, 2002; 23(4)∶ 239.
  6. 6. 　張永軍, 趙永福, 馬秀現(xiàn), 等. 胰、腎聯(lián)合移植術(shù)治療糖尿病合并尿毒癥三例 [Ｊ]. 中華器官移植雜志, 2002; 23(5)∶ 303.
  7. 7. 　Nakhleh RE, Sutherland DE, Tzardis P, et al. Correlation of rejection of the duodenum with rejection of the pancreas in a pig model of pancreaticoduodenal transplantation [Ｊ].Transplantation, 1993; 56(6)∶ 1353.
  8. 8. 　Gruessner RW, Burke GW, Stratta R, et al. A multicenter analysis of the first experience with FK506 for induction and rescue therapy after pancreas transplantation [Ｊ].Transplantation, 1996; 61(2)∶ 261.
  9. 9. 　Gilabert R, Fernandez-Cruz L, Real MI, et al. Treatment and outcome of pancreatic venous graft thrombosis after kidney-pancreas transplantation [Ｊ]. Br J Surg, 2002; 89(3)∶ 355.
  10. 10. 　Cattral MS, Bigam DL, Hemming AW, et al. Portal venous and enteric exocrine drainage versus systemic venous and bladder exocrine drainage of pancreas grafts: clinical outcome of 40 consecutive transplant recipients [Ｊ]. Ann Surg, 2000; 232(5)∶ 688.
  11. 11. 　Kaufman DB, Leventhal JR, Koffron A, et al. Simultaneous pancreas-kidney transplantation in the mycophenolate mofetil/tacrolimus era: evolution from induction therapy with bladder drainage to noninduction therapy with enteric drainage [Ｊ]. Surgery, 2000; 128(4)∶ 726.
  12. 12. 　Terajima H,Shirakata Y,Yagi T,et al.Successful long-term xenoperfusion of the pig liver: continuous administration of prostaglandin E1 and insulin [Ｊ].Transplantation,1997; 63(4)∶ 507.
  13. 13. 　韓永堅(jiān)， 劉牧之主編. 臨床解剖學(xué)叢書(腹盆腔分冊(cè)) [M]. 第1版. 北京: 人民衛(wèi)生出版社, 1996∶ 218~285.