Early Postoperative Impulse Oscillometry Study: Changing Curve And Influencing Factor Analysis

The damage of the pulmonary function by the thoracotomy is the main reason of the postoperative complications. The trauma, pain, drainge and sputum all are the effective factors to the pulmonary function especially within one week after operation. In this period, the mensuration of the pulmonary function is more difficult, because the traditional spirometry depend on the patients' cooperation accurately. Therefore, there were few reports about the pulmonary function within one week after thoracotomy.IOS(impulse oscillometry) is a new technique to mensurate pulmonary function which root in F0T(forced oscillation technique). It has lots of strongpoints such as no cooperate, simpleness, speediness, impersonality, repetitiveness, comprehensiveness, hurtlessness etc. So it is applicable for recentness after thoracotomy.Sixty patients were selected by stochastic method, who received thoracotomy through posterolateral incision without serious preoperative complication. These consist of 31 lobectomies, 2 duble lobectomies, 9 pneumectomies, 3 oesophagus and gastric cardia cases, 2 excision of mediastinal tumor cases, 13 exploratory thoracotomy cases. The IOS values were mensurated respectively on the first, second, third, fifth and seventh day after operation. All of the cases were divided into groups by operation style, age, preoperative lung function, preoperative smoking quantity. The changing curves of IOSwere made and the influence factors were analyzed by SPSS11.0 medical statistic software.The values of Zrs > R5, R20, Fres, X5 (absolute value) after lobectomy, pneumectomy and exploratory thoracotomy rised obviously on the first day, The values of lobectomy and exploratory thoracotomy drop on the second day, but the values of pneumectomy still lasted a higher level. Compared with the other two groups, the difference was significant. The difference between lobectomy and exploratory thoracotomy is not significant.Both groups of the patients' years old >60 and ^60, the IOS values rised obviously on the 1st day. Zrs, Rp, X5 and Fres were significant higher in the group of the patients' years old >60(/5 <0. 05). According to preoperative FEV1, the cases were divided into normal group(FEV1 ^ 70%) and abnormal group(FEVK70%), there were significant difference in Zrs> R5^ R20, Fres between two groups on the 2nd and 3rd day, the abnormal group was higher than normal group.The cases were divided into no smoking group, smoking index^ 400 group and smoking index>400 group, but there is no significant difference among the three groups except Fres of 2nd day and Re of 5th day.This study attested that postoperative trauma, scope of resection, age, preoperative pulmonary function are the most important factors which influencing early postoperative lung function. Pneumectomy makes postoperative pulmonary function lower than the other operation styles, also makes recovery slower; Both the abnormal preoperative...