摘要
目的观察间质性肺炎患者肺移植术后30d生存情况,探讨其围术期死亡的影响因素。方法回顾性分析2020年1月-2022年12月郑州大学第一附属医院行肺移植术治疗的52例间质性肺炎患者临床资料。52例中术后30d存活者44例为存活组,死亡者8例为死亡组。比较2组术前pa(CO_(2))、氧合指数、肺动脉压、血乳酸、中性粒细胞与淋巴细胞比值、血红蛋白、脑钠肽、气道真菌感染、气道细菌感染、CT血管造影异常情况,供肺冷缺血时间、手术时间、失血量、输血量、双肺移植及术中体外膜肺氧合比率,术后pa(CO_(2))、48h氧合指数、肺动脉压、血乳酸、中性粒细胞与淋巴细胞比值、血红蛋白、脑钠肽、C反应蛋白、降钙素原及气道真菌感染、气道细菌感染、气道并发症发生率。多因素logistic回归分析间质性肺炎患者肺移植术后30d死亡的影响因素。结果死亡组术前pa(CO_(2))[58.1(40.3,79.7)mmHg]、血乳酸[1.7(1.1,1.9)mmol/L]及术后气道并发症(62.5%)、气道细菌感染(100.0%)发生率均高于存活组[45.0(37.0,50.2)mmHg、1.0(0.8,1.2)mmol/L、18.2%、61.4%](P<0.05),2组性别比例,年龄,体质量指数,合并高血压、糖尿病、脑梗死、心脏病比率,有吸烟、饮酒史比率,术前肺动脉压、氧合指数、中性粒细胞与淋巴细胞比值、血红蛋白、脑钠肽、血乳酸及气道真菌感染、气道细菌感染、CT血管造影异常比率,供肺冷缺血时间、手术时间、失血量、输血量及双肺移植、术中体外膜肺氧合比率,术后pa(CO_(2))、48h氧合指数、肺动脉压、中性粒细胞与淋巴细胞比值、血红蛋白、血乳酸、脑钠肽、C反应蛋白、降钙素原及气道真菌感染比率比较差异均无统计学意义(P>0.05)。术前pa(CO_(2))(OR=1.127,95%CI:1.022~1.242,P=0.016)、术前血乳酸(OR=7.541,95%CI:1.111~51.159,P=0.039)是间质性肺炎患者肺移植术后30d死亡的影响因素。结论术前pa(CO_(2))、血乳酸�
Objective To observe the survival of interstitial pneumonia patients 30 d after lung transplantation,and to explore the influencing factors of postoperative mortality.Methods A retrospective analysis was conducted on the clinical data of 52 patients with interstitial pneumonia who underwent lung transplantation in the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2022.According to 30-d survival after lung transplantation,52patients were divided into survival group(n=44)and death group(n=8).The preoperative data[pa(CO_(2)),pulmonary artery pressure,oxygenation index(OI),blood lactate,neutrophil to lymphocyte ratio,hemoglobin,brain natriuretic peptide,airway fungal infection,airway bacterial infection,rate of abnormal CT angiography],intraoperative data(donor lung cold ischemia time,surgical time,blood loss,blood transfusion volume,double lung transplantation rate,extracorporeal membrane oxygenation support rate),and postoperative data[pa(CO_(2)),48-h OI,pulmonary artery pressure,blood lactate,neutrophil to lymphocyte ratio,hemoglobin,brain natriuretic peptide,C-reactive protein,procalcitonin,airway fungal infection,airway bacterial infection,incidence rate of airway complications]were compared between two groups.Multivariate logistic regression analysis was conducted to investigate the influencing factors of 30-d mortality after lung transplantation in patients with interstitial pneumonia.Results The preoperative pa(CO_(2)),preoperative lactate,and postoperative incidence rates of airway complications and airway bacterial infection were higher in death group[58.1(40.3,79.7)mmHg,1.7(1.1,1.9)mmol/L,62.5%,100.0%]than those in survival group[45.0(37.0,50.2)mmHg,1.0(0.8,1.2)mmol/L,18.2%,61.4%](P<0.05),and there were no significant differences in the clinical data(gender ratio,age,body mass index,comorbidities as hypertension,diabetes,cerebral infarction and heart disease,percentages of patients with smoking and alcohol consumption history),preoperative data(pulmonary artery pressure,OI
作者
朱展毅
王跃斌
丁志丹
李丰科
赵凯
方泽民
刘晓飞
赵高峰
ZHU Zhanyi;WANG Yuebin;DING Zhidan;LI Fengke;ZHAO Kai;FANG Zemin;LIU Xiaofei;ZHAO Gaofeng(Department of Thoracic Surgery/Lung Transplantation Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)
出处
《中华实用诊断与治疗杂志》
2023年第11期1097-1100,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
郑州市科技协同创新专项计划(XTCX2023009)。
关键词
间质性肺炎
肺移植
围术期死亡
影响因素
interstitial pneumonia
lung transplantation
perioperative mortality
influencing factor
