肺移植国内外进展.ppt

术后30天胸片及胸部CT显示右移植肺清晰，肺通气血流灌注扫描示右侧移植肺血流占90%， UCG示左室内径较术前缩小17%，室缺修补完整无残余分流，术后活动耐力明显改善，62天出院。 术后随访已有5近年，生活质量良好。 16 F，PPH, BLT with ECMO 术前 术后 左室舒张末内径* 23 mm 47 mm 右室舒张末内径* 54.7 mm 28 mm 左房内径* 21 mm 34 mm 主动脉根部内径* 24 mm 25 mm 主肺动脉内径 44.5 mm 22 mm 左肺动脉内径 30.9 mm 14 mm 右肺动脉内径 26.2 mm 14 mm 肺动脉收缩压 159.4 mmHg 三尖瓣和肺动脉瓣无返流 平均肺动脉压 92.4 mmHg 三尖瓣和肺动脉瓣无返流 左室射血分数 82% 69% 右室射血分数 19% 62% 每搏输出量 19.7 ml 63 ml 移植前后心超结果比较（术前及术后2.5月） /versace_baby 国际标准化脑死亡供肺的获取及应用(附3例报告) 南京医科大学附属无锡市人民医院 肺移植中心 陈静瑜 资料与方法 性别年龄 诊断 机械通气 氧合指数 其他 供体一 女性39岁 脑肿瘤术后复发 3天 461 纤支镜检查气管、支气管内无明显感染，听诊两肺均呼吸音清，无罗音。术前胸片均未见明显肺部浸润和异常。术前EB、HIV、CMV、HSV 病毒及乙肝均为阴性。三位供体均同时捐献心、肺、肝、肾和角膜等多个器官。 供体二 男性27岁 脑外伤 12天 310 供体三 男性31岁 脑外伤 6天 420 供 体 资 料 资料与方法 供 体 资 料 家属与脑死亡供体告别 供体肺手术方法 资料与方法 供体获取团队在术前祷告 供体肺手术方法 资料与方法 国际标准化脑死亡供肺的获取及应用 性别年龄 诊断 其他 受体一 男性32岁 支扩伴感染、肺心病、呼衰 感染已控制，无发热、咯血，需间断吸氧 受体二 男性34岁 矽肺终末期、肺动脉高压右心功能不全、呼衰 长期咳嗽、气喘，术前已卧床吸氧治疗 受体三 男性61岁 IPF、肺动脉高压右心功能不全、呼衰 活动后气喘明显，需卧床吸氧 受 体 资 料 Transplant for late stage of Pneumosilicosis 主办国家级继续教育项目5项 ( 2004-2010年) 全国第一至第五届心肺移植会议 * * * This figure includes only the lung transplants that are reported to the ISHLT Transplant Registry. Therefore, these numbers should not be interpreted as the rate of change in lung procedures performed worldwide. * Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 1 year have died. Because the decline in survival is greatest during the first year following transplantation, the conditional survival provides a more realistic expectation of survival time for recipients who s