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摘要: 由于免疫抑制和神经损伤等综合因素的影响,肺移植术后胃肠道并发症的总体发生率较高,可引起受者药物吸收障碍和慢性排斥反应。近年来,关于该并发症的研究逐渐增多,但由于各肺移植中心胃肠道并发症发病情况差异较大,临床医师对其认知并不全面。本文对肺移植术后胃肠道并发症的一般情况、常见类型以及危险因素进行了综述,旨在为肺移植术后胃肠道并发症的综合管理提供参考依据。Abstract: Due to the influence of immunosuppression, nerve injury and other comprehensive factors, the overall incidence of gastrointestinal complications after lung transplantation is relatively high, which can cause drug absorption disorder and chronic rejection. In recent years, more and more studies have been conducted on these complications. However, due to the great difference of the incidence of gastrointestinal complications among lung transplantation centers, clinicians lack of understanding of these. In this article, the general status, common types and risk factors of gastrointestinal complications after lung transplantation were reviewed, aiming to provide reference for comprehensive management of gastrointestinal complications after lung transplantation.
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表 1 肺移植术后胃肠道并发症的基本情况
Table 1. Basic situation of gastrointestinal complications after lung transplantation
研究作者 年份 n 发生率[n(%)] 病死率[n(%)] 主要并发症 Costa HF, et al[3] 2003~2016 274 49 (18) 28 (57) 肠梗阻、腹膜炎、肠穿孔 Paul S, et al[4] 1990~2005 208 90 (43) 11 (12) 胆道疾病、结肠炎、小肠梗阻 Smith PC, et al[5] 1988~1993 75 12 (6) 4 (33) 肠梗阻、膈疝、肠缺血 Grass F, et al[6] 1993~2010 205 127 (62) 4 (3) GERD、结肠炎、胃瘫 Kayawake H, et al[7] 2008~2017 160 58 (36) 2 (4) 胃瘫、GERD、结肠炎 Timrott K, et al[8] 2000~2008 754 55 (7) 12 (22) 肠穿孔、腹膜炎、肠梗阻 Miller CB, et al[9] 1997~2004 229 47 (21) 13 (28) 肠梗阻、消化性溃疡、急性胰腺炎 Zevallos-Villegas A, et al[10] 2008~2015 136 17 (13) 9 (53) 胆道疾病、胃肠道出血、肠穿孔 Lahon B, et al[11] 1988~2009 351 26 (7) 5 (19) 胆囊炎、血管炎、胃十二指肠穿孔 Hoekstra HJ, et al[12] 1990~1999 125 12 (10) -① 肠穿孔、阑尾炎、胆囊炎 注:①-为未提及。 -
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