摘要
目的 总结分析肺移植受者术后并发症和生存预后的影响因素.方法 回顾性分析42例肺移植临床疗效、预后和并发症发生情况,并探讨性别、年龄、原发疾病等因素对受者预后的影响.结果围手术期死亡为14.3%.术后1、3和5年的累积生存率分别为89%、59%和38%.术后1、3和5年生存率COPD组为83%、66% 、45%,非COPD组为78%、17%和17%,P=0.013.伊曲康唑或卡泊芬净预防性抗真菌治疗的受者术后真菌感染的发生率明显降低(P=0.016).术后肺部感染发生率为20%,气管吻合口软化、狭窄发生率9.5%.急性排斥反应发生率为35%,BOS发生率22.5%.再移植2例.结论 原发肺基础疾病是影响肺移植预后的重要因素之一;肺部感染和支气管吻合口软化、狭窄是术后主要并发症.
Abstract
Objective To evaluate the complications and prognostic factors of lung transplantation performed in a single center.Methods A rettospective analysis of demographic and outcome data of lung transplantation was performed.Survival analyses were performed using Kaplan-Meier estimation.Results Between January 2003 and April 2011,42 lung transplant procedures were performed.Overall survival rate at 1,3,and 5 years were 89%,59% and 38%,respectively.1,3,and 5 years survival in patients with COPD was 83%,66% and 45%,respectively,which were better than other primary end stage lung diseases ( 78%,17% and 17%,respectively,P =0.013).Postoperative complications included pulmonary bacterium infection in 8 patients (20%),fungal infection in 12 (30%),and airway complications in4 (9.5%).35% of patients had at least 1 episode of acute rejections within the first year,and 22.5% of patients had BOS.2 patients underwent single lung retransplantation.Conclusion In this single center study,patients with COPD may have a good long-term survival.The most common postoperative complications were pulmonary infection and airway complication.