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1367 我院根据目前临床实践结果，总结出以下体会，供同行参考。 Based on current clinical practice and result s, FAHZU summarized this chapter as a reference for medical workers.
1368 总体遵循探索性，抢救性，高选择，高防护的 原则，在充分、合理、优化的内科治疗后，肺部病变仍无明显好转，严重威胁生命安全时，需考虑肺移植评估。 In general, following the principles of exploration, doing the best to save life, highly selective and high protection, if lung lesions are not significantly improved after adequate and reasonable medical treatment, and the patient is in critical condition, lung transplantation could be considered with other evaluations.
1369 移植前评估 Pre-transplantation assessment
1370 1）年龄：建议＜70岁，70岁以上患者需谨慎评估其他脏器功能及术后恢复能力； (1) Age: It is recommended that the recipients are not older than 70. Patients over 70 years old are subject to careful evaluation of other organ functions and postoperative recovery capability.
1371 2）病程：虽然病程长短与疾病严重程度无直接相关性 (2) The course of the disease: There is no direct correlation between the length of the disease course and the severity of the disease.
1372 但对于病程短于4-6周者，需充分评估是否给予充分的药物、呼吸机辅助和ECMO的支持； However, for patients with short disease courses (fewer than 4-6 weeks), a full medical assessment is recommended to evaluate whether adequate medication, ventilator assistance, and ECMO support have been provided.
1373 3）肺功能状态：肺部CT、呼吸机、ECMO参数可作为参考，需充分评估是否存在逆转机会； (3) Lung function status: Based on the parameters collected from lung CT, ventilator, and ECMO, it is necessary to evaluate whether there is any chance of recovery.
1374 4）其他大脏器功能评估：多数危重症患者长期处于镇静状态，意识状态的判断十分重要的，有条件者建议行头颅CT、脑电图检查。 (4) Functional assessment of other major organs: a. Evaluation of the consciousness status of patients in critical condition using brain CT scan and electroencephalography is crucial, as most of them would have been sedated for an extended period;
1375 心脏评估包括心电图、心超，重点评估右心大小，肺动脉压力，以及左心功能情况。 b. Cardiac assessments, including electrocardiogram and echocardiography that focus on right heart size, pulmonary artery pressure and left heart function, are highly recommended;
1376 血清肌酐、胆红素都应纳入评估范围，合并肝功能衰竭、肾功能衰竭者应等待肝肾功能好转； c.The level s of serum creatinine and bilirubin should al so be monitored; for patients with liver failure and renal failure, they should not be subjected to lung transplantation until the functions of the liver and kidney are recovered.