从肺减容过渡到肺移植*

背景：文献报道肺减容在一部分终末期肺气肿病例可以作为肺移植之前一种过渡外科治疗手段。 目的：探讨终末期肺气肿患者经肺减容后再行肺移植的可行性及疗效。 方法：为经2次肺减容术的1例终末期肺气肿患者进行了左肺移植。 结果与结论：患者术后于32 h顺利脱机,肺移植后无明显急性排异反应及其他明显并发症出现,移植后25 d胸部CT示左肺扩张良好,左肺血液灌注良好, 移植后1个月复查肺功能均明显改善,于移植后35d康复出院。进一步表明,对于已行肺减容的终末期肺气肿患者行肺移植是可行的,能明显改善患者肺功能。 关键词：肺减容;肺气肿;肺移植;终末期;器官移植 doi:10.3969/j.issn.1673-8225.2012.05.043

Lung volume reduction surgery: A transitional treatment prior to lung transplantation

BACKGROUND: Previous studies showed that lung volume reduction (LVR) is considered as a potential palliative surgical option for some patients with end-stage emphysema before lung transplantation surgery. OBJECTIVE: To explore the feasibility and curative effect of lung transplantation for end-stage emphysema who accepted LVR surgery. METHODS: One patient who accepted secondary LVR surgery because of end-stage emphysema was treated with left lung transplantation. RESULTS AND CONCLUSION: The patient weaned from ventilator at 32 hours after the operation. There were no acute rejection and other complications occurred after the operation. CT scan demonstrated the left lung dilatation and blood perfusion was better at postoperative 25 days, and the lung function was significantly improved at postoperative one month and finally discharged from hospital at postoperative 35 days. Further indicates that lung transplantation surgery followed by LVR is feasible and the lung function is improved greatly after the lung transplantation.