梁佳龙, 周锦涛, 陈静瑜, 等. ECMO在肺纤维化合并肺气肿受者肺移植术中的临床应用效果[J]. 器官移植. DOI: 10.3969/j.issn.1674-7445.2024130
引用本文: 梁佳龙, 周锦涛, 陈静瑜, 等. ECMO在肺纤维化合并肺气肿受者肺移植术中的临床应用效果[J]. 器官移植. DOI: 10.3969/j.issn.1674-7445.2024130
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Liang Jialong, Zhou Jintao, Chen Jingyu, et al. Clinical application effect of ECMO in lung transplantation for recipients with combined pulmonary fibrosis and emphysema[J]. ORGAN TRANSPLANTATION. DOI: 10.3969/j.issn.1674-7445.2024130
Citation: Liang Jialong, Zhou Jintao, Chen Jingyu, et al. Clinical application effect of ECMO in lung transplantation for recipients with combined pulmonary fibrosis and emphysema[J]. ORGAN TRANSPLANTATION. DOI: 10.3969/j.issn.1674-7445.2024130
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ECMO在肺纤维化合并肺气肿受者肺移植术中的临床应用效果

Clinical application effect of ECMO in lung transplantation for recipients with combined pulmonary fibrosis and emphysema

    摘要
  • 摘要:
    目的 探讨肺移植术中不同体外膜肺氧合（ECMO）转流方式对肺纤维化合并肺气肿（CPFE）患者预后的影响。
    方法 回顾性分析44例接受肺移植的CPFE患者，并将其分为静脉-静脉ECMO（VV-ECMO）组（30例）和静脉-动脉ECMO（VA-ECMO）组（14例）。比较两组患者术前、术中、术后及随访相关指标。
    结果 与VV-ECMO组比较，VA-ECMO组患者年龄较小，术前肺动脉压力较高，后外侧切口类型较少，手术时间较长，术后支气管胸膜瘘发生率较高（均为P＜0.05）。两组术后肺动脉压力均下降，且VA-ECMO组下降幅度较大（P＜0.05）。两组术后生存率差异无统计学意义（P＞0.05）。
    结论 VA-ECMO和VV-ECMO应用于CPFE患者肺移植术中均安全有效，转流方式对患者的短中期预后无显著影响，其中VA-ECMO更适用于术前肺动脉压较高的患者。

     

    Abstract:
    Objective To investigate the effects of different extracorporeal membrane oxygenation (ECMO) bypass modes on the prognosis of patients with combined pulmonary fibrosis and emphysema (CPFE) during lung transplantation.
    Methods A retrospective analysis was conducted on 44 CPFE patients who underwent lung transplantation, and they were divided into the venous-venous ECMO (VV-ECMO) group (30 cases) and the venous-arterial ECMO (VA-ECMO) group (14 cases). The preoperative, intraoperative, postoperative and follow-up related indicators of two groups were compared.
    Results Compared with the VV-ECMO group, the patients in the VA-ECMO group were younger, had higher pulmonary artery pressure before surgery, fewer posterolateral incision types, longer operation times, and higher incidence of postoperative bronchopleural fistula (all P<0.05). The pulmonary artery pressure decreased after surgery in both groups, with a greater decrease in the VA-ECMO group (P<0.05). There was no statistically significant difference in postoperative survival rates between the two groups (P>0.05).
    Conclusions Both VA-ECMO and VV-ECMO are safe and effective in lung transplant patients with CPFE. The bypass mode has no significant impact on the short and medium-term prognosis of the patients. VA-ECMO is more suitable for patients with higher preoperative pulmonary artery pressure.

     

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