我国肺移植的发展现状：问题与反思  

Current status of lung transplantation in China：problems and perspectives

作　　者：王兴安[1] 姜格宁[1] 

机构地区：[1]同济大学附属上海市肺科医院胸外科,200433

出　　处：《中华外科杂志》2016年第12期881-885,共5页Chinese Journal of Surgery

摘　　要：国内肺移植发展很快，但仍严重滞后，供肺利用和围手术期医疗方面仍有巨大挑战。当前，中国在胸外科、肺内科和重症医学方面已经赶上世界先进水平，肺移植发展的滞后与上述学科的水平不相符。通过对比中国和发达国家在肺移植上的差异，反思中国肺移植存在的问题。首先是多学科团队协作的问题。美国肺移植团队由专职肺移植的内科医师、胸外科医师、护士、呼吸治疗师及可能需要的其他专科医师组成，而中国肺移植团队多由胸外科手术组演化而来，仅在胸外科医师遇到困难时才邀请其他专科医师会诊。团队协作不佳也导致供肺利用率和质量偏低。其次，我们未能将一些新进展应用到肺移植实践中，例如体外肺支持和体外肺灌注技术。国内肺移植的进一步发展，有赖于多学科团队的创新和协作。Despite rapid progress, clinical lung transplantation in China still lags far behind？ A great challenge remains in donor lung utilization and perioperative medicine？ It′s really abnormal that we are so backward in lung transplantation when we have come up with the advanced world levels in thoracic surgery, pulmonology and critical care medicine？ Our shortcomings were analyzed by comparing lung transplantation in China and in the advanced countries？ The first problem is multidisciplinary teamwork？ In the United States, a lung transplant team includes physician specialized in lung transplantation, thoracic surgeons, nurses, respiratory therapists and other specialists possibly needed？ In contrast, our lung transplant teams are derived from thoracic surgery teams？ Other specialists are invited for consultation just when thoracic surgeons are unable to deal with the tough issues in perioperative medicine？ The low utilization and quality of donor lung also result from poor teamwork？ The second problem is that we failed to integrate such advances as extra corporeal lung support and ex vivo lung perfusion into our lung transplant programs？In conclusion, the development of lung transplantation in China is dependent upon an initiative, multidisciplinary team approach.

关 键 词：肺移植 胸外科学 肺医学 重症医学 体外肺灌注 

分 类 号：R655.3[医药卫生—外科学]