肺移植术后胃食管反流病预防和治疗的初步经验

Primary experience on prevention and treatment of gastroesophageal reflux after lung transplantation

目的探讨肺移植术后胃食管反流病预防和治疗的经验。方法终末期肺病患者8例，1例行单肺移植，7例行双肺移植。所有患者术后给予机械通气、液体负平衡、抗感染和抗排斥等治疗。部分患者给予抗胃食管反流病治疗。结果受者早期存活5例，死亡3例。8例患者中5例未行胃食管反流病预防性治疗，其中2例诊断误吸，经抗反流治疗后明显好转；3例常规行胃食管反流病的预防治疗，未见明显误吸，且恢复良好。结论肺移植是治疗终末期肺病的有效方法。胃食管反流病在肺移植术后常见，防治胃食管反流病对于预防术后肺部并发症有重要作用。

Objective To explore the experience on prevention and treatment of gastroesophageal reflux disease （GERD） after lung transplantation. Methods Eight patients with end-stage lung disease re- ceived lung transplantation. Among them, onereceived single-lung transplantationand the others received double-lung transplantation. After the operation, all of the patients received mechanical ventilation, negative fluid balance, antibacterial prophylaxis and immunosuppressive agents. Part of them received anti-gastroesophageal reflux disease therapy. Results Five patients survived and three patients died. Five patients didnt receive prophylactic therapy for gastroesophageal refluxdisease. Two of them were found to suffer from aspiration and recovered after anti-reflux treatment. Three patients received prophylactic therapy for gastroesophageal refluxdisease, and none of them had aspiration. Conclusion Lung transplantation is an accepted treatment for end-stage lung diseases. Gastroesophageal reflux disease is common after lung trans- plantation and prophylactic anti-reflux therapy is important to prevent postoperative pulmonary complications.