终末期肺病肺移植术后并发症的影像学表现

Radiological findings of lung complications after single or bilateral lung transplantation of end-stage lung diseases

目的探讨肺移植术后并发症的影像学改变.方法6例患者进行了同种异体肺移植术,其中4例终末期慢性阻塞性肺疾病患者和1例为中毒性细支气管炎患者接受单肺移植,另1例为外周型肺腺鳞癌并双肺转移接受双肺移植.用胸片及CT观察术后并发症的影像学变化.结果6例肺移植手术全部成功,6例中围手术期3例死亡,3例已存活16～36个月.术后2例发生急性排斥反应,5例出现再移植肺水肿,3例并发肺部感染,2例出现气胸,2例术后1～2个月出现吻合口狭窄.结论及时的胸片和CT检查对肺移植术后并发症的防治有非常重要的指导价值.

Objective To discuss the radiologic features of lung complications after single or bilateral lung transplantation of end-stage lung diseases. Methods Four man with end-stage chronic obstruction pulmonary diseases （COPD） and one man with toxic chemicals bronchiolitis received single-lung transplantation; one man with metastasis of lung adenosquamous carcinoma received bilateral lung transplantation. The chest radiography and CT scan were used to detect the thoracic imaging changes during postoperative period. Results All surgery were successful. Three recipients died of respiratory failure due to severe pneumonia after 22-70 days of the transplantation, and 3 patients are still alive from 16 to 36 months. Two recipients developed acute rejection; 5 cases developed pulmonary reimplantation response;3 man developed pneumonia, and 2 occurred pneumothoraxes. Two recipients had a bronchial stenosis 1 to 2 months after the surgery. Conclusion Thoracic imaging procedures play an important role in the diagnosis of complications and management of lung transplantation.