单肺移植治疗艾森曼格综合征(附1例报告)

Single- lung transplantation on Eisenmenger's syndrome

目的总结单肺移植治疗艾森曼格综合征围手术期处理的经验教训。方法对1例52岁的房间隔缺损合并艾森曼格综合征女性患者在全麻体外循环下行同种异体右全肺移植术,同时行房间隔缺损修补术。供体为32岁男性,术前未作HLA配型,供肺保护采用4℃改良低钾右旋糖酐液(LPD)灌洗,4℃UW液保存。术后给予三联免疫抑制剂。结果术后心肺功能恢复良好。但术后12h发生超急性排斥反应,术后第5天导致急性肝肾功能衰竭,用人工透析维持。第9天出现口腔感染和泌尿系感染,给予口腔护理及氯霉素膀胱冲洗,第12天因全身感染死亡。结论术前供肺保护和手术技巧是单肺移植治疗艾森曼格综合征手术成功的关键;抗排斥和抗感染是手术后处理的重要环节。

Objective：To summarize experience of single-lung transplantation on Eisenmenger＇s syndrome. Methods： A patient with Eisenmenger＇s syndrome was treated by using single-lung transplantation. The immunosuppressive agents were applied after transplantation. Results： Thelung and heart function was good in the patient after operation. But the acute rejection occurred at 12 hours after operation ,the hypohepatia and acute renal failure occurred at 5 day after operation. The patient was died 12 days after operation because general infection. Conclusions： For single-lung transplantation on Eisenmenger＇s syndrome, the anti-infection and antirejection were important ofter operation.