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肺移植术后并发肠气囊肿症3例并文献复习
陈文丽
赵丽
郭丽娟
梁朝阳
陈静瑜
陈文慧
作者及单位信息
·
DOI： 10.3760/cma.j.cn112147-20220106-00022
Pneumatosis cystoides intestinalis in lung transplant recipients: three cases report and literature review
Chen Wenli
Zhao Li
Guo Lijuan
Liang Chaoyang
Chen Jingyu
Chen Wenhui
Authors Info & Affiliations
Chen Wenli
Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
Zhao Li
Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
Guo Lijuan
Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
Liang Chaoyang
Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
Chen Jingyu
Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
Chen Wenhui
Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
·
DOI： 10.3760/cma.j.cn112147-20220106-00022
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摘要

目的对肺移植术后合并肠气囊肿症（PCI）的临床特点和诊治情况进行总结分析。

方法回顾性分析2017年3月至2021年6月中日友好医院肺移植术后所有并发PCI患者的临床资料，并以“肠气囊肿症、肺移植”为中文检索词，“Pneumatosis Intestinalis、Lung Transplantation”为英文检索词检索中国知网、万方、Pubmed数据库相关文献，对入组患者的临床特征、诊疗经过及转归进行归纳分析。

结果本中心肺移植术后发生3例PCI，发病率为0.804%（3/373）。另检索出相关文献13篇，入组病例51例。54例患者中男33例，女21例，中位年龄为55.4岁（22~79岁）。54例患者中64.81%（35/54）因肺纤维化进行肺移植，90.74%（49/54）进行双肺移植。发生PCI时40.7%（22/54）无症状，70.37%（38/54）升结肠受累，64.81%（35/54）横结肠受累，48.1%（26/54）合并气腹，79.63%（43/54）给予保守治疗。从肺移植到诊断PCI的中位时间为210（5~2 495）d。

结论PCI是肺移植术后少见的并发症，最常发生于结肠，无症状者多见，多经保守治疗病情可好转。

音频摘要
PCI是肺移植术后少见的并发症，最常发生于结肠，无症状者多见，多经保守治疗病情可好转。
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Version：v1.60.2
肠气囊肿症;肺移植;气腹
ABSTRACT

ObjectiveTo report the clinical characteristics and treatment courses of pneumatosis cystoides intestinalis(PCI) after lung transplantation(LT).

MethodsWe included all cases of PCI after LT from March 2017 to June 2021 in China‐Japan Friendship Hospital. In addition to our cases, we searched literatures published in Chinese and English languages using China National Knowledge Infrastructure (CNKI), Wanfang Data and PubMed/MEDLINE with the search terms“pneumatosis intestinalis”and“lung transplantation”. The clinical characteristics and treatment courses of all cases were summarized and analyzed.

ResultsThree cases of PCI occurred after LT in this study, with an incidence of 0.804% (3/373). Thirteen related literatures were retrieved, with 51 cases enrolled. The median age of the 54 patients was 55.4 years (22-79 years), with 33 males and 21 females. 64.81% (35/54) of the 54 patients underwent LT for interstitial lung disease and 90.74% (49/54) underwent bilateral LT. Twenty-two cases(40.7%) were asymptomatic when PCI occurred. Thirty-eight cases (38/54,70.37%)had involvement of ascending colon, and 35 cases(35/54,64.81%)had involvement of transverse colon. Forty-three cases(43/54, 79.63%) were treated conservatively. The average interval between transplantation and PCI was 210 (5-2 495) days.

ConclusionPCI is a rare complication after lung transplantation, most often occurring in the colon. Most patients were asymptomatic and could improve by conservative treatments.

Pneumatosis cystoides intestinalis;Lung transplantation;Pneumoperitoneum
Chen Wenhui, Email: mocdef.aabnisiuhailecec

Chen Wenli is working in Department of Pulmonary and Critical Care Medicine, Chengde Medical College Affiliated Hospital

Copyright by Chinese Medical Association
No content published by the journals of Chinese Medical Association may be reproduced or abridged without authorization. Please do not use or copy the layout and design of the journals without permission.
All articles published represent the opinions of the authors, and do not reflect the official policy of the Chinese Medical Association or the Editorial Board, unless this is clearly specified.
引用本文

陈文丽,赵丽,郭丽娟,等. 肺移植术后并发肠气囊肿症3例并文献复习[J]. 中华结核和呼吸杂志,2022,45(07)：671-676.

DOI:10.3760/cma.j.cn112147-20220106-00022

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肠气囊肿症（pneumatosis cystoides intestinalis，PCI）是一种以肠壁黏膜下或浆膜下多发含气囊肿为特征的病变，可发生于消化道任何部位，最常见于结肠，其次是小肠。PCI为少见病，文献报道本病在人群中的发病率为0.03%~0.20% ［ 1 ］ 。PCI分为原发性和继发性。原发性PCI发病率只占15%，继发性 PCI占85% ［ 2 ］ 。PCI常继发于慢性呼吸系统疾病、药物、器官移植和消化道疾病等，但该病发病机制不明 ［ 3 ］ 。研究表明PCI可以继发于骨髓移植 ［ 4 ］ 和实体器官移植 ［ 5 ］ 。国外关于肺移植后并发PCI的报道较少，而国内尚未见关于肺移植并发PCI的病例报道。本研究回顾性分析中日友好医院肺移植科2017年3月到2021年6月肺移植术后继发PCI的3例患者的临床特点并进行相关文献复习，以提高临床医生对该病的认识。
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备注信息
A
陈文慧，Email： mocdef.aabnisiuhailecec
B

陈文丽起草文章及采集数据，赵丽、郭丽娟参与采集数据，梁朝阳、陈静瑜参与课题设计，陈文慧对文章的知识性内容作批评性审阅

C

陈文丽现在承德医学院附属医院呼吸与危重症医学科

D

陈文丽, 赵丽, 郭丽娟, 等. 肺移植术后并发肠气囊肿症3例并文献复习[J]. 中华结核和呼吸杂志, 2022, 45(7): 671-676. DOI: 10.3760/cma.j.cn112147-20220106-00022.

E
所有作者声明无利益冲突
F
中国医学科学院医学与健康科技创新工程项目 (2021-I2M-1-049)
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