体外循环支持下同期双侧大容量全肺灌洗术后重症肺泡蛋白沉积症患者的监护管理  

Care management after bilateral massive whole lung lavage simultaneously supported by cardiopulmonary bypass to cure severe pulmonary alveolar proteinosis

作　　者：王研[1] 杜成[1] 孙思庆[2] 周本昊[1] 王瑛[1] 

机构地区：[1]南京市胸科医院重症医学科,江苏南京210009 [2]东南大学附属中大医院呼吸科,江苏南京210009

出　　处：《现代医学》2015年第4期476-479,共4页Modern Medical Journal

摘　　要：目的:总结体外循环支持下同期双侧大容量全肺灌洗术治疗重症肺泡蛋白沉积症(PAP)的术后监护与治疗经验。方法:分析我院4例体外循环支持下同期双侧大容量全肺灌洗术的重症PAP患者术后生命体征、呼吸氧合功能、机械通气时间及并发症发生、处理情况。结果:本组患者术后出现呼吸功能延迟恢复1例、肢体并发症1例、低氧1例、支气管痉挛1例、低钾血症1例,经积极治疗均顺利康复。结论:体外循环支持下同期双侧大容量全肺灌洗术后的重症PAP患者易出现各种并发症。加强围术期监测,制定合理的术后治疗计划,及时发现并处理并发症,可以为围术期患者的恢复提供有力的保障。Objective： To summarize the experience of postoperative care management after bilateral massive whole-lung lavage simultaneously supported by cardiopulmonary bypass to cure severe pulmonary alveolar proteinosis（PAP）. Methods： From 2011 to 2013, 4 patients suffered from severe PAP received bilateral massive whole-lung lavage simultaneously supported by cardiopulmonary bypass in our institution. Postoperative vital signs, respiratory oxygenation, mechanical ventilation time, and occurrence of complications and their treatment were observed. Results： No death occurred in hospital. Other common complications after procedures such as delayed recovery of respiratory function, lower limb isehemia, hypoxia, bronchospasm and hypokalemia were all cured before discharge. Conclusion： It is safe and feasible to treat severe PAP by bilateral massive whole-lung lavage simultaneously supported by cardiopulmonary bypass. Intensive peri-operative care, reasonable postoperative treatment plan and timely treatment of complications all contribute to improved outcomes.

关 键 词：体外循环 大容量全肺灌洗术 肺泡蛋白沉积症 

分 类 号：R563.9[医药卫生—呼吸系统]