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目的:评估静脉-动脉(V-A)和静脉-静脉(V-V)转流方式的体外膜氧合(ECMO)辅助下的肺移植受者临床特征及预后情况。方法:回顾性分析2016年至2018年南京医科大学附属无锡人民医院开展的ECMO辅助下肺移植手术220例(V-A转流147例，V-V转流73例)的临床资料。比较两组受者临床资料、术后并发症及短期生存状况的差异。结果:V-A组供者性别为女性的比例、手术时间、输血量和尿量均高于V-V组(n P0.05)。ECMO转流时间与术后机械通气时间和短期存活率独立相关，转流时间12.0～23.9 h、24.0～47.9 h和≥48 h的受者术后机械通气时间≥3 d的风险分别是转流时间<12 h者的7.48 (95%CI：2.61～21.49)、12.30(95%CI：4.54～33.33)和16.02(95%CI：5.25～48.84)倍，术后短期死亡的风险分别是转流时间<12 h者的2.21(95%CI：1.00～4.86)、2.73(95%CI：1.34～5.56)和6.63(95%CI：3.23～13.59)倍。n 结论:V-A和V-V转流方式对肺移植受者术后并发症和短期存活率无影响，但转流时间对受者短期生存状况具有预测价值。“,”Objective:To evaluate the clinical characteristics and prognoses of recipients of lung transplantation(LTx)under venous-arterial(V-A)versus veno-venous(V-V)bypass of extracorporeal membrane oxygenation(ECMO).Methods:A total of 220 patients undergoing LTx supported by ECMO were recruited. Based upon the types of ECMO, they were divided into two groups of V-A(147 cases)and V-V(73 cases). Perioperative data of donor/recipient, including postoperative complications and short-term survival rates, were retrospectively analyzed.Results:The proportions of female donors, operative duration, volume of blood transfusion and urine production were higher in V-A group than those in V-V group(n P<0.05). And ECMO bypass time was lower in V-A group than that in V-V group(n P0.05). The extension of ECMO bypass time was correlated with postoperative mechanical ventilation time and short-term survival rate. Compared to patients with a ECMO bypass time < 12 h, the risk of mechanical ventilation ≥3 days was 7.48(95%CI: 2.61~21.49), 12.30(95%CI: 4.54~33.33)and 16.02(95%CI: 5.25~48.84)folds. And the risk of early postoperative death was 2.21(95%CI: 1.00~4.86), 2.73(95%CI: 1.34~5.56)and 6.63(95%CI: 3.23~13.59)folds greater for patients with a bypass time of 12.0~23.9, 24.0~47.9 and ≥48 h respectively.n Conclusions:Under the current regimen of ECMO application, bypass type of ECMO does not affect the postoperative complications and short-term survival rates. Yet ECMO bypass time has a predictive value for short-term survival time of recipients.