肺叶切除术治疗双肺移植术后肺不张疗效分析

李慧星; 毛文君; 陈静瑜; 郑明峰; 叶书高; 何毅军; 刘峰

doi:10.3969/j.issn.1674-7445.2014.01.006

肺叶切除术治疗双肺移植术后肺不张疗效分析

Analysis of curative effect of pulmonary lobectomy on atelectasis after lung transplantation

摘要

摘要:
目的探讨肺叶切除术治疗肺移植术后并发肺叶不张的疗效。
方法 回顾性分析2013年7月实施肺移植术后并发肺不张两例患者的临床资料。1例为囊性纤维化双肺移植后右中上肺重症感染并肺不张,1例为支气管扩张、两肺肺气肿双肺移植后右肺中下叶肺不张。肺切除术前两例患者存在不同程度的肺部感染。两例患者分别进行右移植肺中叶切除术和右移植肺中下叶切除术。
结果两例患者肺叶切除术后感染情况得到有效控制,康复出院。
结论肺移植术后因严重肺部感染、支气管狭窄导致肺叶不张时,行肺叶切除术、切除病变部位能有效地控制此术后并发症。

Abstract:
Objective To investigate the curative effect of pulmonary lobectomy on lobe atelectasis after lung transplantation.
Method Clinical data of two patients with lobe atelectasis after lung transplantation were retrospectively analyzed in July 2013. One case developed severe infection of right middle lobe and lobe atelectasis after double lung transplantation for cystic fibrosis. The other case developed lobe atelectasis of right middle and lower lobe after double lung transplantation for bronchiectasis and pneumonectasis. Before pulmonary lobectomy, both of them suffered from pulmonary infection. Two cases underwent pulmonary lobectomy of middle lobe or middle and lower lobe of right transplant lung respectively.
Result Pulmonary infection was controlled in two cases after pulmonary lobectomy. They were discharged from the hospital and had good quality of life.
Conclusion Pulmonary lobectomy can be performed aggressively for pulmonary atelectasis after lung transplantation due to severe lung infection or bronchostenosis. Removal of diseased region can control the postoperative complication effectively.

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