Abstract:

Objective To explore the effects of different pulmonary hypertension on mechanicalventilation time and extracorporeal membrane oxygenation （ECMO） of patients after lung transplantation. Methods A retrospective analysis was conducted on 101 patients with lung transplantation admitted to the Department of Critical Care Medicine，Wuxi People's Hospital Affiliated to Nanjing Medical University from June 2nd，2018 to May 5th，2020. According to the different degrees of pulmonary hypertension after lung transplantation，the patients were divided into 62 patients with mild pulmonary hypertension group（≤ 49 mmHg，1 mmHg ＝ 0.133 kPa）and 39 patients with moderate and severe pulmonary hypertension group（≥ 50 mmHg）. Cox proportional risk model was used to analyze the effects of pulmonary hypertension on mechanical ventilationtime and ECMO after lung transplantation. The 30 d Kaplan-Meiers survival curve was used to analyze theeffects of different pulmonary hypertension groups on ECMO time and mechanical ventilation time of patients after lung transplantation. Results There were significant differences in age，primary disease，pulmonary hypertension value，ECMO mode and hemoglobin between mild and moderate to severe pulmonary hypertension groups （P ＜ 0.05）. The mechanical ventilation time and ECMO time of the two groups were compared according to the 30 d postoperative survival（P ＜ 0.05）. Univariate Cox regression analysis showed that the mechanical ventilation time and ECMO time of the two groups had statistically significant effects on the survival time after lung transplantation. Multivariate Cox regression analysis showed that the effect of mechanical ventilation time on survival time of patients after lung transplantation was statistically significant. Conclusion Patients with moderate and severe pulmonary hypertension after lung transplantation need longer ECMO time and mechanical ventilation time. 

Key words:

Pulmonary hypertension, Lung transplantation, Mechanical ventilation time, ECMO time

摘要：

目的 通过对肺移植术后患者临床资料的回顾性分析，探索不同肺动脉高压患者对肺移植术后患者的机械通气时间和体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）的影响。 方法 回顾性分析 2018 年 6 月 2 日至 2020 年 5 月 5 日南京医科大学附属无锡人民医院重症医学科纳入 101 例肺移植患者资料，根据肺移植患者术后不同程度的肺动脉高压，将肺移植术后患者分为 62 例轻度肺动脉高压组（≤ 49 mmHg，1 mmHg ＝ 0.133 kPa）和 39 例中重度肺动脉高压组（≥ 50 mmHg）。运用 Cox 比例风险模型进行单因素和多因素分析术后不同肺动脉高压组对肺移植术后机械通气时间和 ECMO 等因素的影响。运用30 d Kaplan-Meiers 生存曲线分析不同肺动脉高压组对肺移植术后患者的 ECMO 时间和机械通气时间的影响。结果 轻度、中重度肺动脉高压组的肺移植术后患者在年龄、原发病、肺动脉高压数值、ECMO 方式、血红蛋白有显著的统计学差异（P ＜ 0.05）。根据术后 30 d 存活情况比较两组机械通气时间和 ECMO 时间有显著的统计学差异（P ＜ 0.05），单因素 Cox 回归分析显示，肺移植术后两组的机械通气时间和 ECMO 时间对生存时间的影响具有统计学意义。多因素 Cox 回归分析显示肺移植术后患者的机械通气时间对生存时间的影响具有统计学意义。 结论 肺移植术后中重度肺动脉高压患者需要更长的 ECMO 时间和机械通气时间。

关键词:

 , 肺动脉高压 , 肺移植 , 机械通气时间 , 体外膜氧合时间