Study On The Sputum Properties In Pneumotectomy And Esophagectomy Patients And The Effects Of Aerosol Inhalation Of Salvia Miltiorrhiza Compound

OBJECTIVES To understand the difference of sputum properties between the patients after pneumotectomy and esophagectomy for guiding the postoperative nursing care, expectorated sputum (ES). from pneumotectomy and esophagectomy patients were investigated; And the effects of Salvia Miltiorrhiza Compound on sputum properties in patients after pneumotectomy were studied.METHODS Expectorated sputum samples from 21 patients after thoracotomy and 18 after esophagectomy were collected. All patients inhaled distilled water by ultrasonical nebulizer. Total sputum leukocyte counts were measured with Popov method, interleukin 8(IL-8) level with radioimmunoassay (RIA) and sputum viscoelasticity with Low Shear 40. In addition, 22 patients after pneumotectomy were enrolled in the second part of the continuing study, in which all patients aerosol inhaled Salvia Miltiorrhiza Compound. ES samples were collected and measured in the same way.RESULTS1> Changes of leukocyte counts The highest sputum leukocyte counts of the pneumotectomy patients were on the second postoperative day(POD), and on the third POD for the esophagectomypatients. There is statistic significance comparing the second, the third and the fifth PODs in the esophagectomy patients.2 % Changes of IL- 8 Decreasing inclination during the first three PODs in the pneumotectomy patients was found, and the sputum IL-8 levels on the fourth day (0.39ng/ml) is significantly lower than those on the first POD (2.6Ing/ml). Sputum IL-8 levels of esophagectomy patients on the second POD were significantly higher than those on the first POD, and then gradually decreased. There was statistic significance of sputum IL-8 level between the two groups on the third and fourth PODs.3 > Changes of rheology The sputum yield stress gradually decreased from 1 to 5 PODs, and it was much higher in the pneumotectomy patients than in the esophagectomy patients without statistic significance. The sputum viscoelasticity in pneumotectomy patients decreased gradually, and it decreased abruptly on the second POD in the esophagectomy patients. The sputum viscoelasticity on the second, the third and the fourth PODs in the pneumotectomy patients was much higher than that in the esophagectomy.4 > Effects of aerosol inhalation of Salvia Miltiorrhiza Compound Postoperative total leukocytes counts of the experiment group decreased day after day and there was significant difference between the non-treated and the experiment groups on the second, third, fourth and fifth PODs. The IL-8 level of the postoperative sputum in experiment group was lower than that of the non-treated group except that on the fourth POD. The yield stress was also lower in experiment group without statistic significance. The viscosity on the first, third, fourth and fifth PODs and elasticity on the first and second PODs ofexperiment group were much lower than that of the non-treated group.CONCLUSIONSPatients after thoracotomy existed apparent respiratory inflammation. On the early days after operation, the sputum yield stress, viscosity and elasticity were much higher, especially for patients after pneumotectomy. Aerosol inhalation of Salvia Miltiorrhiza Compound by ultrasonical nebulizer could diminish the postoperative respiratory inflammation and promote expectorate.