The Relationship Between Fibrinogen Level And Postoperative Pulmonary Complications Following Surgery

Research background:Incidence rate of lung cancer is currently the highest in tumor home and abroad,and among the lung cancer,non-small cell lung cancer occurs mostly.Multimodality treatment using operation as the mainstay of therapy is considered as the most effective means to treat lung cancer at the present time,but surgical complications have long troubled people.Postoperative pulmonary complications have mainly the following aspects:sputum retention,pulmonary infection,pulmonary atelectasis,air leak,bronchospasm,acute lung injury,and acute respiratory distress syndrome.Surgical complications in lung occur mostly 30 days after pneumonectomy,and these complications often lead to death.Research objectives:To understand the relationship between preoperative serum fibrinogen level and postoperative pulmonary complications following surgery on patients with non-small cell lung cancer,and to explore whether the level of plasma fibrinogen before operation is independently prognosticating postoperative pulmonary complications.Research of treatment reducing fibrinogen before operation has preventive and therapeutic effects on postoperative pulmonary complications following non-small cell lung cancer resection.Method:106 patients are randomly selected from those who are in our hospital from Mar.2008 to Mar.2009.In these selected patients whose fg is above 4.0mg/dl are segregated into A group(reducing fibrinogen group) and B group(positive control group),and those whose fg is between 2,0-4.0mg/dl are segregated into C group(negative control group).Those grouped into A will receive treatment by reducing their fibrinogen and after the treatment if their fg is between 2.0-4.0mg/dl and suitable for operation,surgery can be performed.Those who are grouped into B and C and are suitable for operation would undergo operation directly.A case-control study should be carried out to compare different symptoms of patients in the 3 groups mentioned above who have been received operations.Result:Through analyzing there are 25(23.6%)people who get pulmonary complications in the total 106 people of three groups,and in group A there are 6 (18.8%) who get pulmonary complications in the total 32;in group B,13(41.9%) in the total 31;in group C,6(14.0%)in the total 43 people.Differences in pulmonary complications incidence rate between group A and B and between B and C are statistically significant.People in group A and C who have showed pulmonary complications are less than those in group B.Conclusion:Preoperative serum fibrinogen level is one of the important indicators to predict risk on patients with non-small cell lung cancer after lung cancer resection.There are connections between Preoperative serum fibrinogen level and postoperative pulmonary complications:while preoperative serum fibrinogen level is above 400 mg/dl before non-small cell lung cancer surgery,the postoperative pulmonary complications incidence rate is notably higher,such as sputum retention, pulmonary infection,air leak,bronchospasm,acute lung injury,and acute respiratory distress syndrome;while serum fibrinogen level is above 400 mg/dl,significant difference is noted in complications incidence rate between people who have been treated by reducing their fibrinogen and those who do not.