单肺移植治疗终末期肺气肿一例报告

Unilateral lung transplantation in end-stage emphysema:a case report

目的 探讨肺移植治疗终末期肺病肺气肿的手术适应证、手术方式、围术期的处理及术后生存率。方法 2 0 0 2年 9月 2 8日为 1例肺气肿、肺功能重度减损的患者进行左肺移植。结果 术后 93h顺利脱机 ,术后第 9d发生 1次急性排斥 ,经大剂量甲泼尼龙冲击治疗后症状消退 ,术后 4 0d胸部CT示左肺扩张良好 ,左肺血液灌注良好 ,术后肺功能明显改善 ,术后 4 7d出院 ,现已恢复工作。结论 终末期肺气肿是肺移植最常见的手术适应证。单肺移植术后肺功能改善明显。

Objective To explore the operation technique,patient selection,survival rate and perioperative management of lung transplantation for end-stage emphysema.Methods A 56-year-old male with end-stage emphysema was subjected to a left-lung transplantation in our hospital on 28 Sep.2002. The surgical technique used was similar to that mentioned in the literature.Results The patient weaned from ventilator on the next 93 h of operation. Immunosuppression included cyclosporine,mycophenolate mofetil.and corticosteroid. The acute rejection occurred on the 9 th day after operation and cured by bolus methylprednisolone given intravenously. His lung function was improved significantly and he was discharged from hospital 47 days after operation. After discharge from the hospital,the patients could return to an almost normal life.Conclusions End-stage emphysema is the most frequent indication for lung transplantation. The lung function was improved greatly after single-lung transplantations.