肺移植后支气管吻合口并发症的诊治经验

Experience in the diagnosis and treatment of bronchial anastomosis after lung transplantation

目的探讨肺移植术后支气管吻合口并发症发生、预后及诊治对策。方法收集2003年1月至2016年7月接受肺移植的81例次受者的临床资料。分析肺移植受者术后支气管吻合口并发症的发生率以及预后。结果受者肺移植术后支气管吻合口并发症总体发生率为30．9％，其中吻合口感染15例（18．5％），吻合口瘘4例（4．9％），气管狭窄5例（6．2％），气管软化1例（1．2％）。1例患者因支气管吻合口感染死亡，3例患者因支气管吻合口瘘死亡。结论肺移植风险高，技术难度大，术后支气管吻合口并发症以近期并发症为主，总体预后良好。

Objective To assess the incidence and prognosis of the bronchial anastomosis complications following lung transplantation. Methods Between January 2003 and July 2016, all 81 cases after lung transplantation at Department of Thoracic Surgery of Shanghai Pulmonary Hospital, Tongji University were retrospectively analyzed. We analyzed the incidence and prognosis of postoperative complications of bronchial anastomosis in lung transplant recipients. Results The overall incidence of bronchial anastomotic complications was 30. 9%, including anastomotic infection （18. 5%）, anastomotic fistula （4. 9%）, stenosis （6. 2%）, and bronchomalacia （1.2%）. One case died of infection, and 3 cases died of anastomotic fistula. Conclusion The main bronchial anastomosis complications occurred early, and the prognosis was acceptable.