单肺移植治疗终末期肺病（附4例报告）

目的:探讨单肺移植治疗终末期肺病的手术方法、早期临床结果及围手术期处理方法.方法:2006年6月至2007年1月,为4例终末期肺疾病患者施行了单肺移植手术,均为右侧单肺移植.其中第1和第2例为同1天完成.结果:第1例术后合并顽固的铜绿假单孢杆菌和不动杆菌感染,几乎对所有的抗生素耐药,于术后第33天死于严重感染所致的多脏器衰竭.其余3例均顺利出院,目前生活质量明显改善,SaO2和FEV1均显著提高.结论:单肺移植是治疗终末期肺病的有效方法,但术后感染及排异发生率高,加强围手术期处理非常重要.

Clinical report of single lung transplantation for end-stage lung disease(four cases of report)

Objective:To explore the surgical technics,early clinical results and the key point of perioperative management of single lung transplant in treating end-stage lung disease.Methods:From June,2006 to January,2007,4 cases of end-stage lung disease patients received right single lung transplantation.The first and the second case received the operation in the same day.Results:The first case was infected with bacillus pyocyaneus and amotile bacillus after operation,which resisted to almost all kinds of antibiotics.This case died of serious pulmonary infection 33 days postoperatively.The other 3 cases were discharged in 27 days,51 days and 60 days after operation respectively and all were in follow-up.The patients' life quality,SaO2 and FEV1 improved significantly.Conclusion:Single lung transplantation is an effective treatment for end-stage lung disease.But the morbidity and mortality caused by infection and acute rejection after operation are very high.It was very important to enhance the perioperative management of lung transplantation.