肺移植术后支气管消失：序贯气道扩张的作用
Vanishing Bronchus After Lung Transplantation: The Role of Sequential Airway Dilatations.
作者信息
Alraiyes Abdul Hamid, Inaty Hanine, Machuzak Michael S
机构信息
Interventional Pulmonology, Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY ; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University at Buffalo, State University of New York, Buffalo, NY.
Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH.
出版信息
Ochsner J. 2017 Spring;17(1):71-75. doi: 10.1043/1524-5012-17.1.71.
BACKGROUND
Airway complications after lung transplant play an important role in patient survival. Early recognition and treatment of these complications are necessary to help ensure that patients who receive lung transplants have good outcomes.
CASE REPORT
A 61-year-old female with a history of pulmonary venous occlusive disease presented to our hospital for a double-lung transplant. Her postoperative course was complicated by severe primary graft dysfunction. Airway examination showed significant mucosal ischemia distal to the anastomosis bilaterally with diffuse narrowing of all distal bronchial segments. Repeat bronchoscopies with debridement of necrotic material and balloon dilatation of stenotic airways were performed to maintain airway patency.
CONCLUSION
Post-lung transplant airway necrosis and stenosis mandate early identification and treatment. Repetitive bronchoscopies with sequential balloon dilatations are mandatory to prevent future airway stenosis and airway vanishing.
背景
肺移植后的气道并发症对患者生存起着重要作用。早期识别和治疗这些并发症对于确保接受肺移植的患者获得良好预后是必要的。
病例报告
一名有肺静脉闭塞性疾病病史的61岁女性到我院接受双肺移植。她的术后病程因严重的原发性移植物功能障碍而复杂化。气道检查显示双侧吻合口远端有明显的黏膜缺血，所有远端支气管节段弥漫性狭窄。为维持气道通畅，进行了多次支气管镜检查，清除坏死物质，并对狭窄气道进行球囊扩张。
结论
肺移植后气道坏死和狭窄需要早期识别和治疗。必须进行多次支气管镜检查并序贯球囊扩张，以防止未来气道狭窄和气道消失。
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