四例单肺移植受者对侧肺的处理方法与效果

目的探讨单肺移植中受者对侧肺的处理方法与效果。方法回顾性分析2003年1月至2004年8月4例单肺移植受者对侧肺的处理方法。4例中双肺囊肿并感染1例实行右侧单肺移植，对侧肺保留；慢性阻塞性肺疾病（COPD）3例，其中1例对侧肺未手术，1例肺移植术后第47天Ⅱ期实行对侧肺减容术，1例单侧肺移植同时实行对侧肺减容术。结果4例肺移植受者，3例顺利出院存活至今，其中2例存活期超过18个月；住院期间死亡1例。结论终末期COPD患者行单肺移植，如果对侧肺有巨大肺大疱或者重度弥漫性肺气肿，可Ⅰ期手术切除肺大疱或行肺减容术；双肺囊肿患者非移植侧肺如果没有明显反复感染或毁损肺，可不予手术处理。

The management of the contralateral lungs in four cases with single allograft lung transplantation

Objective To report the management of the contralateral lungs in 4 cases with single allograft lung transplantation. [WTHZ]Methods Four cases receiving lung transplantation were analyzed respectively. One presented with bilateral multiple lung cysts and three with chronic obstructive pulmonary disease (COPD) with bilateral bullae. In the case with bilateral multiple cysts, the contralateral lung remained untreated after operation. For the contralateral lungs in the three cases with COPD, one remained untreated, one received lung volume reduction surgery (LVRS) immediately after lung transplantation, and one received LVRS 47 days after lung transplantation. [WTHZ]Results Three patients recovered after operation, and 2 of them survived more than 18 months. One patient with delayed contralateral LVRS died 74 days after lung transplantation. [WTHZ]Conclusions For advanced stage COPD with bilateral bullae, contralateral LVRS may be performed immediately after single lung transplantation. In patient with bilateral cysts only, the resection of the contralateral cysts may be avoided if there is no severe infection.[WTHZ]