肺癌术后肺纤维化急性加重的诊疗进展

特发性肺纤维化（IPF）是一种特殊类型的间质性肺炎，以缓慢进展为特点，其病变局限在肺部，老年人多见，一部分病例会出现急性加重的过程，表现为原有肺部病变突然恶化和致死性的呼吸衰竭，并出现新的肺部阴影和弥漫性肺泡病理改变。特发性肺纤维化急性加重（AEIPF）可发生于接受肺切除术后的原发性肺癌患者，起病通常呈急性或亚急性过程，病因尚不明确，通常认为与不明原因的肺损伤相关，起病隐匿，病情进展迅速，病死率高，而且在临床缺乏常规的预防和治疗措施，成为困扰临床医生的难题。本文就肺癌术后特发性肺纤维化急性加重的病因、发生的危险因素、预测指标、预防、治疗、预后等方面做一系统综述。

Advances in diagnosis and treatment of acute exacerbation of IPF after lung cancer surgery

Idiopathic pulmonary fibrosis (IPF) is a respiratory disease characterized by slow progression. It is a specialtype of interstitial pneumonia. Its pathological changes are confined to lungs. It is common in the elderly. However some cases occur with acute exacerbation that manifested by sudden deterioration of the original pulmonary lesions, fatal respiratory failure and new pulmonary shadow and diffuse alveolar pathological changes. This acute exacerbation of IPF can occur in patients with primary lung cancer after lung resection, usually with an acute or subacute onset. The etiology of acute exacerbation of pulmonary fibrosis after lung cancer surgery is still unclear. It is usually considered to be related to pulmonary injury of unknown causes. Because of its hidden onset, rapid progression, high mortality and lack of routine preventive and therapeutic measures in clinic, it has become a difficult problem for clinicians. This article reviews the etiology, risk factors, predictive indicators, prophylaxis, treatment and prognosis of acute exacerbation of IPF after lungcancer surgery.