合并肺段挫伤供肺肺移植的临床疗效分析

Clinical analysis of lung transplantation from donors combined with pulmonary contusion

目的探讨合并肺段挫伤供肺肺移植治疗终末期肺病的疗效及预后。方法收集73例供、受体的临床资料,根据供肺是否合并挫伤,将供、受体分为挫伤组(各23例,挫伤最大直径5~8 cm)和标准组(各50例)。比较两组受体术后主要临床指标[包括术毕氧合指数、机械通气时间、胸管留置时间、原发性移植物失功(PGD)发生率等]及预后情况。结果两组受体的术毕氧合指数、机械通气时间、胸管留置时间、PGD发生率比较,差异均无统计学意义(均为P>0.05)。标准组和挫伤组受体术后1年存活率分别为74%和83%,两组比较差异无统计学意义(P>0.05)。结论合并肺段肺挫伤(最大直径5~8 cm)的供肺肺移植疗效和预后接近标准供肺移植。

Objective To explore the efficacy and prognosis of lung transplantation from donors combined with pulmonary contusion on the treatment of patients with end-stage lung disease. Methods Clinical data of 73 cases of donors and recipients were collected. The donors and recipients were divided into contusion group（23 cases of donors and recipients, with a maximum diameter of contusion in 5-8 cm） and standard group（50 cases of donors and recipients） depending on combined pulmonary contusion. Major clinical indicators [postoperative oxygenation index, duration of mechanical ventilation and chest tube drainage and incidence of primary graft dysfunction（PGD）] and prognosis of the recipients in both groups were compared. Results The recipients in both groups presented no significant difference in postoperative oxygenation index, duration of mechanical ventilation and chest tube drainage and incidence of PGD（all P〉0.05）. The postoperative 1-year survival of the recipients in standard group and contusion group was 74% and 83%, which presented no statistically significant difference（P〉0.05）. Conclusions The efficacy and prognosis of lung transplantation from donors combined with pulmonary contusion（with a maximum diameter of 5-8 cm） are comparable to those of lung transplantation from standard donors.