【摘要】 目的总结单肺移植治疗终末期肺病的早期临床结果和经验。方法2003年1月至2005年9月,为11例终末期肺疾病患者施行了单肺移植术,其中右侧单肺移植7例,左侧单肺移植4例。有2例受者接受同一供者的左、右肺。结果目前有6例单肺移植受者术后生存1年以上,其中3例存活2年以上;3例存活6个月以上。9例存活的受者生活均能自理,活动良好。术后2个月肺功能复查:动脉血氧分压(PaO2)均>80mm Hg,较术前提高37.6%;有8例受者第1秒用力呼气量(FEV1)较术前提高165.2%。2例死亡的受者中,1例因术中大出血死亡;1例淋巴管平滑肌瘤受者术后3个月后死于顽固性乳糜胸。受者术后急性排斥反应平均发生率为1.2次;4例术后并发曲霉菌感染;3例术后出现支气管狭窄;2例术后并发严重肺部感染;1例术后36h出现缺血/再灌注损伤;1例术后7d并发胃底黏膜撕脱继发上消化道大出血;1例术后1年出现慢性排斥反应。结论单肺移植是治疗终末期肺疾病的有效方法。肺移植术后并发症发生率高,应进行有效的预防和治疗。更多还原

【Abstract】 Objective To summarize the initial outcome of single lung transplantation in the treatment of endstage pulmonary disease.Methods From Jan.2003 to June 2005,11 cases were subjected to single lung transplantation consecutively at our hospital.Of the 11 patients with end-stage pulmonary diseases,7 underwent the right single lung transplantation,and 4 the left procedure.Among them,2 patients received single lung transplantations by the same donor.Results Of the 11 patients,6 cases have been alive for more than 1 year（including 3 cases been alive for more than 2 years）.Three cases have been alive for more than 6 months.Lung function examination was done 2 months after lung transplantation.Nine patients showed normal PaO₂ values（more than 80 mm Hg） with an average improvement of（37.6%）,and 8 obtained an average improvement of（165.2%） in FEV₁.One case died of bleeding intra-operatively.One case died of chylothorax at 3rd month post-operatively.The incidence of acute rejection was（1.2） averagely in this group.As to other complications,aspergillosis occurred in 4 cases,severe lung infection in 2 cases,reperfusion-injury-induced pulmonary edema in 1 case at 36th h postoperatively,and upper alimentary canal hemorrhage in 1 case at 7th day.Chronic rejection occurred in 1 case at first year postoperatively.Conclusions Single lung transplantation is effective in treating end-stage pulmonary disease.The incidence of complication was higher after lung transplantation.Effective prevention and management should be emphasized.更多还原