单肺移植手术前后的供体肺保护

目的 探讨肺移植手术前后供体肺保护的处理经验.方法 回顾性分析了2003年1月至2006年8月本院施行的同种异体单肺移植手术9例,其中左侧3例,右侧6例.冷低钾肺保护液灌注移植肺,术后三联免疫抑制剂抗排斥,并分析术后的胸片评分、氧合指数及肺动脉压变化情况.结果 供体肺缺血时间平均为(308.6±50.8)min.8例患者均成功脱离呼吸机并存活过围手术期(＞30 d),术后拔除气管插管时间平均(4.8±3.4)d,1例未能脱机并在术后22 d死亡.结论 肺保护需要在多个环节中加以控制,不同时期的保护侧重点不同.

The protection of graft lung in lung transplantation

Objective To report the experience on the protection of graft lung in lung transplantation in a single center since 2003.Methods Between January 2003 and August 2005,9 single lung transplantations flushed with cold low potassium solution were performed.Maintenance immunosuppression was triple-drug regimens:steroids,mycophenolate mofetil and tacrolimus.Chest radiograph score,oxygenation index,and pulmonary artery pressure in the early stage post-transplantation were reviwed.Results The mean ischemic time was(308.6±50.8)minutes.Eight cases whose mean extubation time was(4.8±3.4)days survived more than 30 days post-transplantation.One ease couldn't be free of mechanical ventilation and finally died 22 days post-transplantation.Condusions Many aspects are important to graft lung protection and details are different in courses of harvesting,operation and post-operation.