矽肺伴甲亢患者肺移植术中及术后反复室颤:附1例报告并文献复习  

Recurrent ventricular fibrillation during and after lung transplantation in patients with silicosis and hyperthyroidism : a case report with literature review

作　　者：练巧燕 徐鑫[1] 韦兵[1] 郝哲学 肖东[1] 黄丹霞[1] 李璇[1] 巨春蓉[1] Lian Qiaoyan Xu Xin Wei Bing Hao Zhexue Xiao Dong Haang Danxia Li Xuan Ju Chunrong(State Key Lab of the Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong, China)

机构地区：[1]广州医科大学附属第一医院广州呼吸疾病研究所呼吸疾病国家重点实验室,广东广州510120

出　　处：《实用器官移植电子杂志》2017年第5期351-354,共4页Practical Journal of Organ Transplantation(Electronic Version)

摘　　要：目的探讨矽肺伴甲亢患者肺移植术中及术后反复室颤的高危因素,以及术前对其进行有效的干预,降低手术风险。方法回顾性分析2017年1月广州医科大学附属第一医院收治的1例矽肺伴甲亢患者肺移植的临床资料。常规入院查体,术前药物治疗原发性甲状腺功能亢进症,术后转入重症监护病房(ICU)并给予药物治疗。结果患者男性,69岁,因矽肺、呼吸功能衰竭至我院行肺移植术,术前评估诊断为原发性甲状腺功能亢进症,经内分泌科规范诊治,甲亢得到良好控制后行肺移植手术,术中及术后出现反复室颤,经积极抢救成功出院,术后随访3个月,患者恢复良好。结论此病例出现室颤的高危因素可能为年龄及肺动脉高压;对于伴甲亢的肺移植患者,术前一定要积极干预并监测甲状腺功能及心脏受累情况。Objective To investigate the risk factors of recurrent ventricular fibrillation in patients with silicosis and hyperthyroidism during and after lung transplantation,and how to reduce the risk of operation. Methods The clinical data of one patient with silicosis and hyperthyroidism who underwent recurrent ventricular fibrillation during and after lung transplantation was analyzed retrospectively. The patient with physical examination was treated with primary hyperthyroidism preoperative and taked into the intensive care unit（ICU） postoperative. Results A 69-year-old male patient needed lung transplantation because of respiratory failure with silicosis, and a diagnosis of hyperthyroidism was also made in the same patient. After a standardized treatment in the department of endocrinology, hyperthyroidism was well controlled,and lung transplantation was performed. However,recurrent ventricular fibrillation occurred during and after the operation. After successful emergency treatments,the patient recovered and discharged. Postoperative follow-up was conducted for three months, the patient recovered well. Conclusion The risk factors for recurrent ventricular fibrillation in this case may be age and pulmonary hypertension. For lung transplant patients with hyperthyroidism,actively intervene and monitor of the thyroid function and cardiac involvement should be emphasized.

关 键 词：矽肺 甲亢 肺移植 心室颤动 

分 类 号：R655.3[医药卫生—外科学]