限制性胸部对肺移植后的长期肺功能参数的影响,在患有间歇性肺病的患者中
Keita Nakanishi1,2, Thomas Schweiger1, Stefan Schwarz1
1Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
概括
在间歇性肺病 (ILD) 患者的肺移植 (LTx) 结果与胸部限制无关,结果相似. 术前胸腔大小不会显著影响长期肺功能或LTx后的存活率.
科学领域:
- 肺部医学 肺部医学
- 胸部外科手术 胸部外科手术
- 移植免疫学 移植免疫学
背景情况:
- 间歇性肺病 (ILD) 导致慢性肺收缩,导致隔膜升高.
- 胸部限制的程度在ILD患者之间有所不同,影响了肺移植 (LTx) 候选人和结果.
- 术前胸腔体积 (实际与预测的肺总容量比率) 与ILD中的LTx结果之间的关系尚不清楚.
研究的目的:
- 调查手术前胸腔限制对ILD患者肺功能和LTx后生存的影响.
- 为了比较ILD患者之间的术后和长期结果,具有低和高的实际和预测的肺总容量比率.
- 评估胸壁合规性对ILD中LTx结果的影响.
主要方法:
- 在欧洲中心对ILD患者进行170次LTx手术的回顾性分析 (09/2011-12/2022).
- 根据手术前实际与预测的肺总容量比率,患者分为两组:低 (<0.55) 和高 (≥0.55).
- 术后参数 (通风,ICU/住院) 和长期结果 (肺功能,生存) 的比较.
主要成果:
- 在气管切除术,再输管,机械通风持续时间或ICU/住院期间,两组之间没有显著差异.
- 在高a/pTLC比率组中,早期术后肺功能更好,但长期差异并不显著.
- 低A/PTLC比率和高A/PTLC比率组之间的五年整体生存率是可比的.
结论:
- 虽然在技术上具有挑战性,但在胸部受限的ILD患者中的LTx显示了与胸部保存患者相比类似的外科术后过程.
- 在接受LTx的ILD患者中,术前胸部限制的程度不会显著影响长期肺功能和整体存活率.
- 结果表明,改善胸壁的遵守可能会减轻手术前限制对LTx结果的影响.
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