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肺移植术后的气道并发症。

Airway complications after lung transplantation.

机构信息

Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

Pulmonary, Critical Care and Sleep Medicine Consultants, Houston Methodist, Houston, TX 77030, USA.

出版信息

Thorac Surg Clin. 2015;25(1):55-75. doi: 10.1016/j.thorsurg.2014.09.008.

Abstract

Airway complications after lung transplantation present a formidable challenge to the lung transplant team, ranging from mere unusual images to fatal events. The exact incidence of complications is wide-ranging depending on the type of event, and there is still evolution of a universal characterization of the airway findings. Management is also wide-ranging. Simple observation or simple balloon bronchoplasty is sufficient in many cases, but vigilance following more severe necrosis is required for late development of both anastomotic and nonanastomotic airway strictures. Furthermore, the impact of coexisting infection, rejection, and medical disease associated with high-level immunosuppression further complicates care.

摘要

肺移植后的气道并发症对肺移植团队构成了巨大挑战,从罕见的影像学表现到致命事件均有发生。确切的并发症发生率因事件类型而异,目前对气道病变仍没有统一的特征描述。其管理也多种多样。在许多情况下,单纯观察或单纯球囊支气管扩张术即可,但对于更严重的坏死,需要警惕吻合口和非吻合口气道狭窄的迟发性发展。此外,合并感染、排斥反应以及与高水平免疫抑制相关的内科疾病的影响也使治疗更加复杂。

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