肺移植术后持续雾化治疗对肺功能及相关并发症的影响

The impact of continuous nebulization therapy on pulmonary function and related complications after lung transplantation

    摘要
  • 摘要:
    目的  探讨肺移植术后持续雾化治疗对肺移植受者肺功能及相关并发症的影响。
    方法  回顾性分析郑州大学第一附属医院肺移植外科在2013年6月至2024年12月行同种异体肺移植的71例受者的一般资料。根据受者出院后是否持续接受雾化治疗3个月以上分为观察组（持续雾化治疗）和对照组（自行终止雾化治疗）。主要观察指标为受者术后6个月时的肺功能指标，包括第1秒用力呼气容积占预计值百分比（FEV1% pred）、用力肺活量占预计值百分比（FVC% pred）、第1秒用力呼气容积与用力肺活量比值占预计值百分比（FEV1/FVC% pred）、25%用力肺活量时的用力呼气流量占预计值百分比、50%用力肺活量时的用力呼气流量占预计值百分比、75%用力肺活量时的用力呼气流量占预计值百分比、经单次呼吸法测定的校正后一氧化碳弥散量占预计值百分比、校正后一氧化碳弥散量与肺泡容积比值占预计值百分比，同时分析受者术后肺部感染年发生率、生存率及严重气道并发症未发生率。
    结果  肺移植术后6个月时，观察组受者的FEV1%pred、FVC% pred均优于对照组受者FEV1% pred为76%（60%，91%）比67%（62%，78%），FVC% pred为（75 ± 13）%比（69 ± 11）%，均为P＜0.05。观察组的肺部感染年均发生率低于对照组（P = 0.023），其发生风险为对照组的0.485倍。两组间的中位生存时间和严重气道并发症未发生率差异均无统计学意义（均为P＞0.05）。
    结论  肺移植术后持续雾化治疗能有效改善受者的肺功能，降低肺部感染的年发生率，对肺功能的长期维护具有积极作用。

     

    Abstract:
    Objective  To investigate the impact of continuous nebulization therapy after lung transplantation on pulmonary function and related complications in lung transplant recipients.
    Methods  A retrospective analysis was conducted on the general data of 71 recipients who underwent allogeneic lung transplantation at the Department of Thoracic Surgery, the First Affiliated Hospital of Zhengzhou University, from June 2013 to December 2024. Recipients were divided into observation group (those who continued nebulization therapy for more than 3 months after discharge) and control group (those who discontinued nebulization therapy on their own). The main observation indicators were pulmonary function indicators at 6 months after surgery, including forced expiratory volume in the first second as a percentage of predicted value (FEV1% pred), forced vital capacity as a percentage of predicted value (FVC% pred), ratio of forced expiratory volume in the first second to forced vital capacity as a percentage of predicted value (FEV1/FVC% pred), forced expiratory flow at 25%, 50% and 75% of forced vital capacity as a percentage of predicted value, and the percentage of predicted value of corrected carbon monoxide diffusion capacity measured by single-breath method, as well as the ratio of corrected carbon monoxide diffusion capacity to alveolar volume as a percentage of predicted value. Additionally, the annual incidence of postoperative pulmonary infections, survival rate and the rate of no severe airway complications were analyzed.
    Results  At 6 months after lung transplantation, the FEV1% pred and FVC% pred of the observation group were better than those of the control group FEV1% pred was 76% (60%, 91%) vs. 67% (62%, 78%), FVC% pred was (75 ± 13)% vs. (69 ± 11)%, both P<0.05. The observation group had a lower annual incidence of pulmonary infections compared to the control group (P = 0.023), with a risk of 0.485 times that of the control group. There were no statistically significant differences between the two groups in median survival time and the rate of no severe airway complications (both P>0.05).
    Conclusions  Continuous nebulization therapy after lung transplantation may effectively improve pulmonary function, reduce the annual incidence of pulmonary infections, and play a positive role in the long-term maintenance of pulmonary function.

     

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