Abstract:

Objective To retrospectively summarize the perioperative clinical data of patients with endstage pulmonary arterial hypertension undergoing lung transplantation， and to analyze the recovery of cardiac function after surgery. Methods A retrospective analysis was conducted on six patients with end-stage pulmonary arterial hypertension who underwent lung transplantation at the Department of Lung Transplantation of ChinaJapan Friendship Hospital from March 2017 to June 2024. The general information of the patients before surgery， preoperative cardiac function， perioperative use of ECMO and IABP， and the recovery of cardiac function after surgery were analyzed. Results Among the six patients， three were male， and the median age was 33.5 years old. Four patients were diagnosed with idiopathic pulmonary arterial hypertension， and two had Eisenmenger's syndrome. All patients underwent a detailed cardiac function assessment before surgery. All six patients underwent double lungtransplantation with VA-ECMO assistance. The duration of ECMO assistance was 2 ～ 7 d， with a median time of 4 d. Two patients used IABP. Three patients developed left heart dysfunction after the surgery. But after effective treatment， all patients' cardiac function recovered during the perioperative period. Postoperative echocardiographic results showed that the relevant indicators of cardiac function of all the patients returned to normal， with statistically significant differences compared to preoperative levels（ P ＜ 0.05）. Conclusion Double lung transplantation is the last treatment option for patients with end-stage pulmonary arterial hypertension. Perioperative circulatory support measures， such as VA-ECMO and IABP， are beneficial for the recovery of cardiac function in such patients. 

Key words:

Pulmonary hypertension , Lung transplantation , Cardiac function , Extracorporeal membrane oxygenation

摘要：

目的 通过对终末期肺动脉高压肺移植患者术前及术后临床资料的回顾性总结，分析患者术 后心功能的恢复情况。 方法 回顾性分析 2017 年 3 月至 2024 年 6 月中日友好医院肺移植科收治的因终 末期肺动脉高压接受肺移植治疗的患者共 6 例，分析了患者术前的一般资料、术前心功能、围手术期体外 膜肺氧合（extracorporeal membrane oxygenation， ECMO）及主动脉球囊反搏（intra-aortic balloon pump， IABP）应 用、手术及术后心功能恢复情况。 结果 6 例患者中男性 3 例，中位年龄为 33.5 岁，4 例原发病为特发 性肺动脉高压，2 例原发病为艾森曼格综合征。所有患者术前均接受了详细的心功能评估。6 例患者均接受 了 VA-ECMO 辅助的双肺移植，ECMO 辅助时间为 2 ～ 7 d，中位时间为 4 d。2 例患者应用了 IABP。术后 3 例患者出现了左心功能不全，经积极治疗，所有患者围手术期心功能均得以恢复。术后心脏超声结果显示， 患者术后心脏超声相关指标均恢复正常，与术前相比均有统计学差异（P ＜ 0.05）。 结论 双肺移植是终 末期肺动脉高压患者最后的治疗选择，围手术期 VA-ECMO 及 IABP 等循环支持手段有助于术后患者心功能 的恢复。 

关键词:

肺动脉高压 , 肺移植 , 心功能 , 体外膜肺氧合