单肺移植治疗终末期肺疾病

目的：探讨肺移植治疗终末期肺疾病的手术适应证、手术方式、围术期的处理及术后生存率。方法：2006年1月20日为1例肺气肿、肺纤维化、肺功能重度减损的患者进行左肺移植。结果：患者术后24h顺利脱机。术后连续5d甲强龙冲击预防急性排斥，术后第9d发生急性排斥反应，随后发生肺感染，低心排，经对症治疗后好转，术后40d胸部CT示左肺脓胸形成，经保守治疗，肺功能明显改善，术后63d出院。结论：终末期肺纤维化是肺移植最常见的手术适应证，单肺移植术后肺功能改善明显。

Unilateral Lung Transplantation For Lung Diseases in Final Stage

Objective:To discuss the indication,technique of Lung transplantation for lung diseases in final stage,and perioperative management of the survival rate.Methods: 1 patient with emphysema,pulmonary fibrosis and severe impairment in lung function performed left lung transplantation on Jan 20,2006.Results: The patient weaned from ventilator at postoperative 24 hours.Immunosuppresive indicine including cyclosporine,mycophenolate mofetil and corticosteroid was given for 5 days.Acute rejection occured at 9 day and lung infection,lower heart output occured soonafter.The condition improved after symptomatic treatment.Chest CT showed empyema at 40 day.Lung function improved after expectant treatment.The patient was discharged form hospital at postoperative 63 day.Conclusion:Pulmonary fibrosis in final stage is the commonest indication for lung transplantation,Unilatral lung transplantaton can improlve lung function.