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目的:探讨肺移植治疗终末期特发性肺纤维化合并扁平胸的临床特点及供受体匹配的研究进展。方法:患者女，40岁，以“间断咳嗽伴胸闷、气短2年，加重1个月”入院。38岁时被诊断为特发性肺纤维化，随着病情进展肺活量逐渐下降，胸廓逐渐扁平、膈肌逐渐上抬。回顾性分析其临床资料并进行文献复习。以“肺移植”和“扁平胸”为检索词检索中国知网及万方医学网中文文献数据库；以“lung transplantation”及“flat chest””为检索词检索PubMed数据库，检索时间截止到2022年7月。结果:2021年7月26日顺利为患者完成了同种异体序贯式双肺移植，术后分别于18、38 h成功撤除体外膜氧合（extracorporeal membrane oxygenation，ECMO）和呼吸机，术后2周顺利出院。移植后患者胸壁扁平情况逐渐改善。目前肺移植术后1年，随访病情良好。检索到相关英文文献9篇，除外1篇综述文章外，其中5篇患者资料相对完善，共43例，男性22例，女性21例，年龄范围24~58岁；活体双侧肺叶移植11例，尸体双肺移植14例，尸体单肺移植18例。另外，尚有3篇文献对肺移植合并扁平胸患者进行初步探讨分析，未明确患者资料信息。结论:对于终末期限制性肺疾病合并获得性扁平胸同时接受肺移植的患者，可适当选择稍大的供肺；同时围术期进行强化肺康复运动训练，有助于逆转平胸、提高移植后肺功能。

Objective:To investigate the clinical characteristics of lung transplantation in the treatment of end-stage idiopathic pulmonary fibrosis complicated with flat chest and to describe the advances in donor-recipient size matching.Methods:A 40-year-old female patient was admitted with "intermittent cough accompanied by chest tightness and shortness of breath for 2 years, aggravated for 1 month". At the age of 38 years, she was diagnosed with idiopathic pulmonary fibrosis. With the progression of the disease, the lung capacity gradually decreased, the thoracic wall gradually flattened, and the diaphragm gradually lifted. The clinical data and literature review were retrospectively analyzed. "Lung transplantation" and "flat chest" were used as search terms to search the Chinese literature databases of CNKI and Wanfang Medical Network, and "lung transplantation" and "flat chest" were used as search terms to search the PubMed database until July 2022.Results:On July 26, 2021, we successfully completed the sequential double lung transplantation for the patient. Extracorporeal membrane oxygenation (ECMO) and mechanical ventilation were successfully weaned off for 18 h, 38 h postoperatively, respectively, and the patient was discharged from hospital two weeks after operation. Her chest wall flattening gradually improved after the transplant. At present, 1 year after lung transplantation, the follow-up condition of the patient was well. Nine relevant English literatures were retrieved, except for one review article. Among them, 43 cases (22 males and 21 females, aged 24 to 58 years) had relatively complete data in 5 literatures. There were 11 cases of living bilateral lobar transplantation, 14 cases of cadaveric double lung transplantation, and 18 cases of cadaveric single lung transplantation. In addition, there were still 3 literatures on the preliminary discussion and analysis of patients with lung transplantation complicated with flat chest, but the patient information was not clear.Conclusions:For patients with end-stage restrictive lung disease complicated with acquired flat chest and receiving lung transplantation, a slightly larger donor lung can be selected appropriately, and perioperative intensive pulmonary rehabilitation exercise training can help to reverse flat chest and improve lung function after transplantation.