单肺移植手术前后的供体肺保护

The protection of graft lung in lung transplantation

目的探讨肺移植手术前后供体肺保护的处理经验。方法回顾性分析了2003年1月至2006年8月本院施行的同种异体单肺移植手术9例，其中左侧3例，右侧6例。冷低钾肺保护液灌注移植肺，术后三联免疫抑制剂抗排斥，并分析术后的胸片评分、氧合指数及肺动脉压变化情况。结果供体肺缺血时间平均为（308．6±50．8）min。8例患者均成功脱离呼吸机并存活过围手术期（〉30d），术后拔除气管插管时间平均（4．8±3．4）d，1例未能脱机并在术后22d死亡。结论肺保护需要在多个环节中加以控制，不同时期的保护侧重点不同。

Objective To report the experience on the protection of graft lung in lung transplantation in a single center since 2003. Methods Between January 2003 and August 2006, 9 single lung transplantations flushed with cold low potassium solution were performed, Maintenance immunosuppression was triple-drug regimens： steroids, myeophenolate mofetil and tacrolimus, Chest radiograph score, oxygenation index,and pulmonary artery pressure in the early stage post-transplantation were reviwed, Results The mean isehemie time was （308.6 ± 50.8 ）minutes, Eight cases whose mean extubation time was （4, 8 ± 3.4） days survived more than 30 days post-transplantation, One ease eouldn＇ t be free of mechanical ventilation and finally died 22 days post-transplantation. Conclusions Many aspects are important to graft lung protection and details are different in courses of harvesting, operation and post-operation.