肺移植术后气道并发症专家共识  

Expert consensus on airway complications after lung transplantation

作　　者：中华医学会呼吸病学分会 中华医学会器官移植学分会 广东省基层医药学会 李时悦[2] 陈静瑜 巨春蓉[4] 吴波[5] Chinese Thoracic Society;Chinese Society of Organ Transplantation;Guangdong Association of Primary Medicine;Li Shiyue;Chen Jingyu;Ju Chunrong;Wu Bo(不详;Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou Institute of Respiratory Health,National Clinical Research Center for Respiratory Disease,Guangzhou 510145,China;Department of Lung Transplantation,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Organ Transplantation,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510145,China;Department of Lung Transplantation,Wuxi People's Hospital,Wuxi 214023,China)

机构地区：[1]不详 [2]广州医科大学附属第一医院呼吸与危重症医学科、广州呼吸健康研究院、国家呼吸系统疾病临床医学研究中心,广州510145 [3]浙江大学医学院附属第二医院肺移植科,杭州310009 [4]广州医科大学附属第一医院器官移植科,广州510145 [5]无锡市人民医院肺移植科,无锡214023

出　　处：《中华结核和呼吸杂志》2025年第4期318-328,共11页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：肺移植是治疗终末期肺病的唯一有效手段,随着手术技术和术后管理方案的优化,其数量在全球范围内呈稳步增长的趋势。气道并发症(airway complication,AC)是肺移植术后最主要的并发症,包括气道狭窄、气管支气管软化、缺血坏死及吻合口瘘等,总发生率为15%~20%,严重影响移植受者的生活质量及生存率,其中气道狭窄最为常见。肺移植受者AC包括大气道和小气道,前者绝大多数发生于术后早期(<1年),本共识主要针对的AC特指大气道AC。普遍认为,支气管血供受损是不同原因导致AC发生的共同途径。对于术后如何管理AC患者,尤其是对于医生的专业介入操作技术要求较高,国内尚缺乏统一的诊疗体系。本共识提出了对肺移植术后AC的诊断、治疗选择、干预方式、干预方法及注意要点,希望未来能够更好地改善患者的预后,供国内同行参考借鉴。Lung transplantation is the only effective treatment for end-stage pulmonary disease.As surgical techniques and post-operative management protocols have been optimised,the number of lung transplantations has steadily increased worldwide.Airway complications(AC),which include airway stenosis,tracheobronchomalacia,ischemic necrosis,and anastomotic leaks,are one of the most common complications following lung transplantation,with an overall incidence ranging from 15%to 20%.These complications have a significant impact on the quality of life and survival rate of transplant recipients,with airway stenosis being the most common.In lung transplant recipients,AC can affect both large and small airways,with the majority of large airway complications occurring within the first year after surgery.This consensus focuses specifically on AC of large airways.It is widely recognized that impaired bronchial blood supply is a common underlying cause of AC due to a variety of factors.The post-transplant management of AC,particularly the technical requirements for specialized interventional procedures,remains a major challenge.Currently,there is no standardized diagnostic and therapeutic approach within the country.This consensus aims to unify and propose guidelines on the diagnosis,treatment options,interventional strategies,methodologies,and key considerations for the management of AC after lung transplantation,with the hope of improving patient outcomes and serving as a reference for practitioners in the field.

关 键 词：气道狭窄 气道并发症 气管支气管软化 肺移植 

分 类 号：R655.3[医药卫生—外科学]