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青少年百草枯中毒后肺移植1例并文献复习

孟凡杰, 张岩, 蔡宏飞, 等. 青少年百草枯中毒后肺移植1例并文献复习[J]. 器官移植, 2024, 15(1): 112-117. doi: 10.3969/j.issn.1674-7445.2023175
引用本文: 孟凡杰, 张岩, 蔡宏飞, 等. 青少年百草枯中毒后肺移植1例并文献复习[J]. 器官移植, 2024, 15(1): 112-117. doi: 10.3969/j.issn.1674-7445.2023175
Meng Fanjie, Zhang Yan, Cai Hongfei, et al. Lung transplantation after paraquat poisoning in an adolescent: one case report and literature review[J]. ORGAN TRANSPLANTATION, 2024, 15(1): 112-117. doi: 10.3969/j.issn.1674-7445.2023175
Citation: Meng Fanjie, Zhang Yan, Cai Hongfei, et al. Lung transplantation after paraquat poisoning in an adolescent: one case report and literature review[J]. ORGAN TRANSPLANTATION, 2024, 15(1): 112-117. doi: 10.3969/j.issn.1674-7445.2023175

青少年百草枯中毒后肺移植1例并文献复习

doi: 10.3969/j.issn.1674-7445.2023175
基金项目: 吉林省重点研发计划项目(JJKH20211163KJ);吉林省市厅局级重点研发计划项目(2021JC013)
详细信息
    作者简介:
    通讯作者:

    李洋(ORCID 0000-0001-8523-5332),博士,主任医师,研究方向为肺移植及肺癌,Email:liyang99@jlu.edu.cn

  • 中图分类号: R617, R563

Lung transplantation after paraquat poisoning in an adolescent: one case report and literature review

More Information
  • 摘要:   目的  总结百草枯中毒患者中毒后移植时机以及相关处理措施对预后的影响。  方法  回顾性分析1例百草枯中毒行双肺移植术治疗患者的临床资料,总结分析该例患者的临床表现、辅助检查以及诊治经过。  结果  1例17岁青少年在摄入25%百草枯20~30 mL后出现恶心、呕吐、咳嗽伴全身乏力入院。患者经对症支持治疗后,氧饱和情况无改善,肺部纤维化持续进展,遂在体外膜肺氧合(ECMO)辅助下行序贯双侧肺移植。经术后康复治疗,并积极防治并发症,患者于术后50 d出院。  结论  百草枯中毒后的移植时机可选择在肝肾功能开始恢复时,围手术期主动、有针对性地预防潜在致病性细菌感染,以及早期康复训练有助于改善肺移植受者的预后。

     

  • 图  1  患者入院到术前的血气结果变化

    Figure  1.  Changes in blood gas results between admission and pre-operation

    图  2  肺移植术前及术后肺部CT图像

    注:A图示双侧肺纤维化进展;B图示肺移植术后肺部CT未见纤维化。

    Figure  2.  CT images of lung before and after lung transplantation

    图  3  患者入院到术前肝肾功能变化

    Figure  3.  Changes of liver and kidney function between admission and pre-operation

    表  1  文献报道的百草枯中毒肺移植受者的临床资料

    Table  1.   Clinical data of paraquat poisoning lung transplant recipients reported in the literature

    研究者 年份 患者年龄
    (岁)
    术前肝
    功能
    术前肾
    功能
    中毒到移植
    的时间(d)
    ECMO使用
    时间(d)
    ECMO
    方式
    肺移植
    类型
    术后生存
    时间
    Matthew H, et al[4] 1968 15 异常 异常 6 单肺 19 d
     Cooke NJ, et al[12] 1973 18 异常 异常 10 单肺 12 d
     未列出[13] 1985 31 异常 19 14 V-V 双肺 110 d
     Walder B, et al[14] 1997 17 异常 44 44 体外循环 单肺 >2年
     Jiao GH, et al[15] 2014 24 稳定 稳定 56 44 V-V 双肺 >5年
     Jiao GH, et al[15] 2018 45 稳定 稳定 38 38 V-V 双肺 >3年
     Jiao GH, et al [15] 2020 38 稳定 稳定 27 27 V-A 双肺 >7个月
     Jiao GH, et al [15] 2021 30 稳定 稳定 28 28 V-V 双肺 >7个月
     Tang X, et al[16] 2015 21 恢复 恢复 56 44 V-V 双肺 >1年
     Jiang WZ, et al[17] 2019 26 58 35 V-V/V-A 双肺 >1年
     Wu Y, et al[18] 2022 18 34 34 双肺 >1年
      注:①-为文献未报道。
        ②V-A 为静脉-动脉。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2023-09-13
  • 录用日期:  2023-11-06
  • 网络出版日期:  2023-11-29
  • 刊出日期:  2024-01-11

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