Objective. To investigate the changes and influencing factors of early postoperative pulmonary functionof thoracotomy.Methods. Pre-and early postoperative pulmonary function was studied in 64 consecutive cases withopt...Objective. To investigate the changes and influencing factors of early postoperative pulmonary functionof thoracotomy.Methods. Pre-and early postoperative pulmonary function was studied in 64 consecutive cases withoptimal thoracotomy. Pain assessment was done before pulmonary function test, and the chief complaintsof patients were recorded after the procedure. The changing curves of pulmonary function were done andthe differences associated with groups, surgical styles, pain assessment, epidural analgesia, chief com-plaint and preoperative conditions were analyzed.Results. Pulmonary function was severely lowered to about 40% of the base line on the first day,and it was rehabilitated to about 60% of the base line on the eighth day. There was a greater gradienton the recovery curve on the 3rd and 4th days. Epidural analgesia was able to improve pain relaxationand pulmonary function in some degree. Single-factor analysis showed that postoperative pain, postopera-tive day and surgical style were the significant influencing factors for early postoperative pulmonary func-tion. By multiple-factor analysis, preoperative pulmonary function, age and postoperative pain were themain factors, while surgical style had only weak effect on it.Conclusions. Early postoperative pulmonary function is severely impaired by thoracotomy. It rehabili-tate gradually with time. Improvement of preoperative pulmonary function, reducing surgical procedure in-juries, especially injury to respiratory muscle system, and enough postoperative pain relief are the mostimportant means that would reduce pulmonary function impairment and consequently reduce postoperativepulmonary complications.展开更多
Objective To evaluate the effects of lung volume reduction surgery (LVRS) on early lung function and pulmonary hemodynamics in severe chronic obstructive pulmonary disease (COPD). Methods 31 patients with severe COPD ...Objective To evaluate the effects of lung volume reduction surgery (LVRS) on early lung function and pulmonary hemodynamics in severe chronic obstructive pulmonary disease (COPD). Methods 31 patients with severe COPD underwent LVRS, bilateral LVRS in 11 patients and unilateral in 20 patients. The results of lung function (FEV1, RV, TLC), arterial blood gas analysis (PAO2, PACO2 ) and color Doppler echocardiography (CD,CI,FS,EF,PAP) were analyzed before and 3 month after LVRS in 26 cases. Results FEV1, RV and TLC were improved significantly after surgery ( P 【 0. 01). PaO2 increased (P 【 0. 05 ) and PaCO2, decreased postoperatively (P 【 0. 01). According to the Doppler echocardiography, there were no statistic differences in cardiac functions (CO, CI, FS, EF, and PAP) between pre- and post-operation. The 6-minute-walk-distance in 26 patients was (227 ± 88) m, significantly increased after surgery. Conclusion LVRS is effective in the treatment of patients with severe COPD. 3 months after operation, the展开更多
文摘Objective. To investigate the changes and influencing factors of early postoperative pulmonary functionof thoracotomy.Methods. Pre-and early postoperative pulmonary function was studied in 64 consecutive cases withoptimal thoracotomy. Pain assessment was done before pulmonary function test, and the chief complaintsof patients were recorded after the procedure. The changing curves of pulmonary function were done andthe differences associated with groups, surgical styles, pain assessment, epidural analgesia, chief com-plaint and preoperative conditions were analyzed.Results. Pulmonary function was severely lowered to about 40% of the base line on the first day,and it was rehabilitated to about 60% of the base line on the eighth day. There was a greater gradienton the recovery curve on the 3rd and 4th days. Epidural analgesia was able to improve pain relaxationand pulmonary function in some degree. Single-factor analysis showed that postoperative pain, postopera-tive day and surgical style were the significant influencing factors for early postoperative pulmonary func-tion. By multiple-factor analysis, preoperative pulmonary function, age and postoperative pain were themain factors, while surgical style had only weak effect on it.Conclusions. Early postoperative pulmonary function is severely impaired by thoracotomy. It rehabili-tate gradually with time. Improvement of preoperative pulmonary function, reducing surgical procedure in-juries, especially injury to respiratory muscle system, and enough postoperative pain relief are the mostimportant means that would reduce pulmonary function impairment and consequently reduce postoperativepulmonary complications.
文摘Objective To evaluate the effects of lung volume reduction surgery (LVRS) on early lung function and pulmonary hemodynamics in severe chronic obstructive pulmonary disease (COPD). Methods 31 patients with severe COPD underwent LVRS, bilateral LVRS in 11 patients and unilateral in 20 patients. The results of lung function (FEV1, RV, TLC), arterial blood gas analysis (PAO2, PACO2 ) and color Doppler echocardiography (CD,CI,FS,EF,PAP) were analyzed before and 3 month after LVRS in 26 cases. Results FEV1, RV and TLC were improved significantly after surgery ( P 【 0. 01). PaO2 increased (P 【 0. 05 ) and PaCO2, decreased postoperatively (P 【 0. 01). According to the Doppler echocardiography, there were no statistic differences in cardiac functions (CO, CI, FS, EF, and PAP) between pre- and post-operation. The 6-minute-walk-distance in 26 patients was (227 ± 88) m, significantly increased after surgery. Conclusion LVRS is effective in the treatment of patients with severe COPD. 3 months after operation, the
