| Complications after thoracotomy are mainly atelectasis, hypoxemia, pulmonary infection, arrhythmia, etc. These postoperative complications are closely related to systemic inflammatory response and the extent of incision pain. Interleukin-6 (IL-6) and C-reactive protein (CRP) are two major inflammatory response in the media, both in the inflammatory response in patients with the occurrence and development of the process has played a very important role, the recent study showed that perioperative IL-6 and CRP changes is closely related to the occurrence of postoperative complications. Because incision pain after thoracotomy, the Patient thoracic exercise is limited, decreased respiratory function, leading to pulmonary atelectasis, pneumonia, lung abscess, such as the occurrence of pulmonary complications, which cause hypoxemia , arrhythmias, so that preoperative occult ischemic heart disease sudden attack. Either directly or indirectly, these complications increase levels of inflammatory mediators, thereby exacerbating the inflammatory response in patients, cause multiple organ dysfunction (MODS). Therefore, lower plasma levels of inflammatory mediators and effective analgesia on the prognosis of patients has a very active role. Intercostal nerves cryoanalgesia after thoracotomy surgery as a way of its simple, safe and effective, has been widely used clinical. Xuebijing as an effective pro-inflammatory factor antagonist, is widely used in sepsis and multiple organ dysfunction syndrome treatment, as well as in lung disease, renal transplantation has been applied.Objective Through the combined with intercostal nerves cryoanalgesia and Xuebijing on Post-thoracotomy patients with plasma IL-6, C-reactive protein and clinical observation, to explore the effect of this combination of Traditional Chinese Medicine with Western Medicine method for thoracotomy in patients with inflammatory mediators and their clinical significance.Methods Selected close to the surgical site, surgical cases in the same surgical methods as to minimize the differences in observed indicators because of Surgical factors caused by, Therefore select line left thoracotomy in patients with esophageal carcinoma 60 cases, they were randomly divided into 3 groups, control group, cryoanalgesia group (frozen group), combined with cryoanalgesia and Xuebijing group (United group). Severity of pain was graded by Visual Analogue Scale (VAS), recorded after 48h in patients with VAS score situation. Plasma IL-6 concentration levels by peripheral venous blood in vitro were measured before 1d and at 2h, 6h, 24h, 3d and 6d after operation. Plasma CRP concentration levels by peripheral venous blood in vitro were measured before 1d and at 2h, 24h, 3d and 6d after operation, on the measured results were compared to observe the different methods effect of patient in perioperative plasma IL-6 and CRP concentration levels. Record three groups postoperative complications and compared. Observation of combined with Intercostal Nerves Cryoanalgesia and Xuebijing on the impact of complications after thoracotomy and clinical significance.Results The day before surgery, each group preoperative plasma IL-6, CRP concentration was no significant difference. After thoracotomy in patients with plasma IL-6, CRP concentrations were significantly higher than preoperative. IL-6 level after operation in all patients was significantly higher than that before surgery, reach its peak at 2h after operation. At 6h after operation plasma IL-6 started to decline, after 3-6d plasma IL-6 dropped to close to preoperative levels. CRP level was no significant change at 2h after operation. CRP level at 1d after operation in patients of all groups was signifieantly higher than preoperative, 3-6 days after operation it's significant downturn. IL-6, CRP level were similar in each groups, but the increased rate were different. Patients with frozen group at each phase of the IL-6 levels below the control group, and at 2h, 6h, 24h after operation measured level of IL-6 has significantly differences with the control group (P<0.05). In united group patients the level of IL-6 at each phase is lower than the control group and the frozen group, and at 2h, 6d after operation measured level of IL-6 has signifieantly differences with the control group (P<0.05) .And at 6h, 24h, 3d after were very signifieantly different with control group (P<0.01) . At 2h after patients in each group detected no signifieantly difference in CRP, patients with frozen Group at after operation 24h, 3d measured level of CRP was lower than the control group (P<0.05) . In united group, postoperative 24h, 3d measured concentration of CRP was significantly lower than control group (P<0.01) . At 6d after operation measured concentrations of CRP was lower than the control group (P<0.05) . At 48h after operation, the VSA score of Control group was 7.25±2.33, the total effective rates were 35%. Frozen group was 2.1±2.22, and the total effective rates were 95%. There was significant difference between the frozen group and the control group (P<0.01) . United group was 2.25±2.24, the total effective rates were 90%. There was significant difference between the united group and the control group (P<0.01), with no difference between frozen group. Control group has three cases of postoperative complications in patients, the incidence of complications was 15%; frozen group has two cases, the incidence of complications was 10%, which is lower than the control group; United group without postoperative complications is lower than the frozen and control groups, but each group had no statistical significance.Conclusion Freezing intercostalnerves during thoracotomy can effectively prevent postoperative chest pain, also can reduce post-operative plasma IL-6, CRP levels, reduce the occurrence of postoperative complications. Combined with intercostal nerves cryoanalgesia and Xuebijing can further reduce the peripheral blood of patients with IL-6 and CRP levels .Tips combined with Intercostal Nerves Cryoanalgesia and Xuebijing this Traditional Chinese medicine with Western Medicine method on prevention of complications after thoracotomy has been effective.
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