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患者为34岁妇女,1989年因囊状纤维化行心肺移植术,术后早期曾并发出血(需手术止血)、双侧锁骨下静脉血栓形成与绿脓杆菌败血症。使用的免疫抑制剂有强的松龙,环孢菌素与硫唑嘌呤。为监控免疫排斥反应,于X线透视指导下定期行支气管肺活组织检查(TBLB),每次检查用4mm鳄嘴钳采集8～12块肺组织标本。 3年中共行TBLB8次,无出血或气胸并发症。术后3月时患者有闭塞性细支气管炎的组织学证据,增加类
The patient was a 34-year-old woman who underwent cardiopulmonary transplantation for cystic fibrosis in 1989 and had early postoperative complications of hemorrhage (requiring surgery to stop bleeding), bilateral subclavian vein thrombosis, and Pseudomonas aeruginosa sepsis. The use of immunosuppressive agents are prednisolone, cyclosporine and azathioprine. To monitor immune rejection, bronchopulmonary biopsy (TBLB) was performed on a regular basis under the guidance of X-ray. Eight to 12 lung tissue specimens were collected with 4mm alligator pliers for each test. TBLB 8 times in 3 years without bleeding or pneumothorax complications. The patient had histologic evidence of obliterative bronchiolitis at 3 months after surgery and increased the class