肺移植后的肺炎
Masashi Furukawa1, Ernest G Chan2, Jenalee N Coster2
1Division of Thoracic Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA. furukawam@upmc.edu.
General Thoracic and Cardiovascular Surgery Cases
|November 8, 2024
概括
肺炎,充满空气的囊,可以在肺部移植后由于肺炎而发展. 这个案例表明,保守的管理可以解决它们,但破裂和肺胸是风险.
科学领域:
- 肺部病理学 肺部病理学
- 移植手术 移植手术
- 临界护理医学 临界护理医学
背景情况:
- 肺细胞是肺移植后的罕见并发症,通常与肺炎或创伤有关.
- 这个病例涉及一个44岁的男性,患有肺静脉封闭性疾病和肺高血压,他接受了双重肺移植.
- 患者患有严重的原发性移植功能障碍和双边下叶肺炎,并患有黄金葡萄球菌和Burkholderia cepacia感染.
研究的目的:
- 报告肺移植后肺炎细胞形成的情况.
- 讨论移植后肺炎细胞的管理和结果.
- 突出潜在的并发症和保守的治疗方法为肺移植后的肺肺.
主要方法:
- 一位患有初级移植功能障碍和肺炎的双重肺移植接受者接受了抗生素 (trimethoprim-sulfamethoxazole,meropenem,minocycline) 和易感定位治疗.
- 静脉外体膜氧化 (ECMO) 和呼吸器支持被用于呼吸管理.
- 对于正在发展的肺结核,选择了保守的治疗方法,然后对自发性肺胸部进行穿皮排水.
主要成果:
- 患者在肺炎部部位出现了肺结核,该肺结核最初增加了大小.
- 保守的治疗,包括倾斜的定位和药物治疗,导致呼吸系统逐渐改善.
- 肺结核自发破裂,导致无症状的肺胸部,通过穿皮排水成功管理. 肺结核消失了,患者随着肺结核的缩小而出院.
结论:
- 肺移植后的肺炎部位可能会出现肺炎.
- 对于移植后的肺结核,保守的治疗可能是有效的,但对破裂和肺胸部等并发症的警至关重要.
- 这一案例凸显了肺移植后肺炎细胞的自发解脱和成功的保守治疗的可能性.
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