Early Postoperative Pulmonary Function Study:: Changing Cure And Influencing Factors Analysis

Objeetive Observed in patients with unilateral chest lobectomy, wedge resection of lung perioperative pulmonary function and blood gas changes. Joint animal experiments, compared before and after single-lung ventilation changes in lung tissue microstructure.Methods1. Animal experiments :The rats were divided into four groups. Group A: Performing OLV by clamping. Group B: Right bronchial intubation OLV. Group A and Group B was divided into A1, A2, A3, and B1, B2, B3 according to different ventilation time. There are two control groups. Group C: total lung ventilation group, which divided into C1, C2, C3 by the corresponding time with the experimental group. Group D: Vacuity contrast group. Take the lung tissue for Western blotting, observed the expression of AQP-5.2. Part of clinical trials : Pre-and early postoperative pulmonary function was detected in 40 consecutive cases with optimal thoracotomy . chief complaint and preoperative conditions were analyzed using SPSS13.0 medical statistic software.Results1. Animal experiments :Compared the expression of AQP-5, group A, B and C were less than group D (P<0.05), A, B, C compared within each group were significant differences (P<0.05); There is no significantly difference among the group A1, B1 and C1 (P>0.05); group A2 was less than group B2 and group C2(P<0.05),and there is no significantly difference between B2 and C2; Group A3 and group B3 were less than group C3 (P<0.05),Group A3 was less than group B3(P<0.05).2. Part of clinical trials:Postoperative day 1, lung function decreased to the preoperative (28±11)% after the next day to continue to reduce to (27±10)%, 3 to 6 days after surgery restored relatively quickly, after 10 back to the days before surgery (41±11)%. Univariate analysis, with or without smoking history (F = 6.315, P <0.05), gender (F = 10.861, P <0.05), postoperative analgesia (F = 18.389, P <0.05 ) on the impact of early postoperative pulmonary function. Surgical, anesthesia ventilation methods on postoperative lung function had no effect. Multivariate analysis, preoperative pulmonary function, smoking history, age, pain of traumatic stress reactions are the factors of early postoperative pulmonary function . Conclusions1. Animal experiments :Mechanical ventilation can reduce the expression of rat AQP-5, and time-dependent. Performing OLV by clamping and right bronchial intubation OLV have higher effect on the expression of rat AQP-5 than total lung ventilation, the former is more obvious.2. Part of clinical trials:Early postoperative lung function in patients undergoing thoracic surgery severely damaged, with the gradual recovery time after surgery. Effectively improve the preoperative pulmonary function, national smoking cessation campaign to reduce intraoperative trauma and damage to the respiratory muscles, adequate postoperative analgesia, reduced postoperative pulmonary function is an important method of pulmonary complications.