单肺移植治疗终末期肺病(附4例报告)

Clinical report of single lung transplantation for end-stage lung disease(four cases of report)

目的:探讨单肺移植治疗终末期肺病的手术方法、早期临床结果及围手术期处理方法。方法:2006年6月至2007年1月,为4例终末期肺疾病患者施行了单肺移植手术,均为右侧单肺移植。其中第1和第2例为同1天完成。结果:第1例术后合并顽固的铜绿假单孢杆菌和不动杆菌感染,几乎对所有的抗生素耐药,于术后第33天死于严重感染所致的多脏器衰竭。其余3例均顺利出院,目前生活质量明显改善,SaO2和FEV1均显著提高。结论:单肺移植是治疗终末期肺病的有效方法,但术后感染及排异发生率高,加强围手术期处理非常重要。

Objective：To explore the surgical technics,early clinical results and the key point of perioperative management of single lung transplant in treating end-stage lung disease. Methods：From June,2006 to January,2007,4 cases of end-stage lung disease patients received right single lung transplantation. The first and the second case received the operation in the same day. Results ：The first case was infected with bacillus pyocyaneus and amotile bacillus after operation, which resisted to almost all kinds of antibiotics. This case died of serious pulmonary infection 33 days postoperatively. The other 3 cases were discharged in 27 days,51 days and 60 days after operation respectively and all were in follow-up. The patients＇ life quality, SaO2 and FEV1 improved significantly. Conclusion：Single lung transplantation is an effective treatment for end-stage lung disease. But the morbidity and mortality caused by infection and acute rejection after operation are very high. It was very important to enhance the perioperative management of lung transplantation.