总结上海市胸科医院近10年肺移植手术和围术期处理的经验。

回顾性分析2007年1月—2016年12月在上海市胸科医院进行的肺移植手术患者的临床资料，其中单肺移植6次(包括2例再移植，2例单侧肺叶移植)，双肺移植24次。患者的基础疾病分别为特发性肺纤维化14例，慢性阻塞性肺疾病8例，弥漫性支气管扩张3例，肺移植术后闭塞性细支气管炎2例，肺泡细胞癌1例，肺淋巴管平滑肌瘤病1例，肺纤毛不动症1例。分析肺移植患者术后1、3、5年的累计生存率和术后主要死亡原因。

肺移植术后90 d内病死率为13.3%(4/30)，其中2例(6.7%)死于术后30 d内，主要死亡原因为循环衰竭和心力衰竭；另2例的主要死亡原因是脑血管意外和气道出血感染。1、3、5年的累计生存率分别为60%、50%和41%，随访3年内死亡的主要原因为肺部感染和吻合口并发症；3年后死亡的主要原因为闭塞性细支气管炎综合征。

肺移植技术已经较为成熟，是一种治疗终末期良性肺病的有效手段。

To share the experience of 10 years of perioperative management for lung transplantation.

A retrospective study of transplantation cases from Jan 2007 to Dec 2016 in Shanghai Chest hospital was conducted. There were 6 cases of single lung transplantation (2 cases of re-transplantation, 4 cases of lobe transplantation) and 24 cases of double lung transplantation. There were 14 cases of IPF, 8 cases of COPD, 3 cases of bronchiectasis, 2 cases of BOS , 1 case of bronchoalveolar carcinoma, 1 case of LAM and 1 case of immotile cilia syndrome. The cumulative survival rate and the major causes of death after 1, 3 and 5 years after operation were analyzed.

30-day mortality was 6.7%(2/30). Circulatory and cardiac failure were the main causes. 90-day mortality was 13.3% (4/30). Stroke and massive airway bleeding were another two causes. 1, 3 and 5-year survival rates were 60%, 50%, 41% respectively. Pneumonia and anastomosis complications were the main causes of death in the first 3 years after transplantation. BOS was the main cause of death after the first 3 years of transplantation.

Lung transplantation was an effective treatment method in treating various end stage benign lung diseases.