体外膜肺氧合长时间辅助新型冠状病毒肺炎危重型康复期双肺移植一例术后管理

Practice of double lung transplantation of a patient supported by long time ECMO caused by severe COVID-19

针对新型冠状病毒肺炎(COVID-19)所致晚期肺纤维化,肺移植是一种可供选择的治疗方案。部分COVID-19危重型康复期患者新型冠状病毒核酸检测阴性,但因肺纤维化无法撤除体外膜肺氧合(ECMO)和机械通气。2020年4月,华中科技大学同济医学院附属协和医院为1例ECMO长时间辅助的COVID-19危重型康复期患者行双肺移植,通过对出血、原发性移植物失功及感染等术后并发症的精心治疗,术后获得康复。本文回顾其术后管理经过,以期为相关病例治疗提供参考。

Lung transplantation is an alternative treatment for advanced pulmonary fibrosis caused by Corona Virus Disease 2019(COVID-19).The 2019-nCoV nucleic acid test of these patients during the rehabilitation period was negative,but extracorporeal membrane oxygenation(ECMO)and mechanical ventilation assistance could not be removed because of their own pulmonary fibrosis.This article gives a case of a critically ill recovery patient with COVID-19 in Wuhan in April 2020.This patient underwent double lung transplantation after long-term ECMO assistance.Due to careful perioperative treatment,this patient obtained postoperative recovery and provided experience for the treatment of related cases.