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The Study on Lung Function and Arterial Blood Gas Analysis in Lung Cancer Patients Perioperative

Author: WangBiao
Tutor: YuZaiCheng
School: Anhui Medical University,
Course: Surgery
Keywords: lung cancer perioperative arterial blood gas analysis lung function
CLC: R734.2
Type: Master's thesis
Year: 2011
Downloads: 56
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Abstract

Objective:To study the change of lung function and arterial blood gas in perioperative care of non-small cell lung cancer (NSCLC) patients after treatment with pneumonectomy. we got the correction coefficient of prediction equation for lung function and provide the theoretical basis for the surgical treatment of NSCLC patients at the edge of high risk.Methods:We collected the data of 36 NSCLC patients accepted the pneumonectomy in our department from August to December in 2010. Among the 36 patients there were 20 males and 16 females, aged 37 to 80 and average age was 59.04. Arterial blood gas, lung function and breath holding test were examined at 9p.m in someone day within one week before pneumonectomy. Arterial blood gas analysis and breath holding test were carried out without oxygen inhalation at 24h,48h and 72h after operation. Arterial blood gas, lung function and breath holding test were examined in one week and one month after operation and six different time points were collected to examine.After examination all the values were got to compare and these comparison including:1.lung function and blood gas between foreoperation and postoperation. 2. predictive and measured values of the lung function after operation. 3.lung function and blood gas of different pneumonectomy. All the datas were indicated as mean±standard deviation(x±s). The comparison between two groups used T-test and one factor analysis of variance between many groups.Different with prediction equation of lung function proposed we put forward correction equation to find out the rule of blood gas in perioperative care. Results: (1) arterial blood gas and partial pressure of oxygen(PaO2) was significantly lower after Pneumonectomy, its minimum occurred at the 48h(P<0.01)and to rised since 72h. But 48h.one week and one month after the operation the values were statistically significant different (P<0.01),the other values were not significant differences (P>0.05). (2)The PaO2 of multiple lobectomy was significantly lower than the single lobectomy (P<0.05), 24h and 48h after the operation, the early postoperative period (P<0.01). (3)all values of lung function declined in various degrees after operation comparing with foreoperation. among the values of ventilatory function such as VCM, FEV1, FEV1% pred ,MVV, MVV% pred, FVC, FVC% pred, and ventilatory index (DLVO% pred ) were statistically significant different from those of postoperation. Ventilatory index DLCO, DLCO/VA were significantly different before and after the operation(P<0.05), one week and one month after the operation, FEV1 % pred, FVC, FVC% pred, MVV, MVV% pred were differernt(P <0.05), and there were no significant differences between the other values. (4) The measured values of lung function one month after the surgrey were higher than the predictive values. FEVI,MVV,MVV% pred between the two groups was significantly different(P<0.01) ; the results of air exchanging:DLCO/VA, difference between the the two groups was significantly different(P<0.01), DLCO% pred, DLCO / VA% pred, there was difference between the two groups (P <0.05), other air exchanging values were not different from DLCO(P >0.05). Based on the equation: P= measured value of one month after operation/ predictive value of one month after surgery, the correction coefficient P is 1.3 and 1.2 when the ventilation and air exchanging values were used repctively.(5)one month after the pneumonectomy, the decreasing percentage of lung function was proportional to the number of penumonectomy, and there was significant difference in the ventilation function between single and multiple lobectomy (P <0.01), but no significant difference in the air exchanging function (P >0.05). Conclusion:1. The PaO2 decreased significantly in the early period after the operation and to the minimum at 48h, then gradually recoveride.2. In the early period after pneumonectomy, there was significantly difference of the ventilation function, however, there was no difference of exchanging function. And the correction coefficient P is1.3 and 1.2 when the ventilation and air exchanging values were used respectively.3. lung function after the multiple lobectomy decreased significantly comparing with the single lobectomy.4. The evaluation of lung function before operation should be associated with the results of the arterial blood gas analysis, pulmonary function and breath test.

The Study on Lung Function and Arterial Blood Gas Analysis in Lung Cancer Patients Perioperative

Abstract

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