Clinical Observation Of Pulmonary Atelectasis Post-thoracotomy Patients

Objective: Pulmonary atelectasis is the common complication after post- thoracotomy,if the treatment is not timely it may cause hypoxemia and the increasing of pulmonary vascular resistance, seriously it may cause severe complications such as: acute lung injury,acute respiratory distress syndrome and pulmonary Infections.But at home and abroad, scholars have not made a systematical and profound study of atelectasis after post-thoracotomy, some identify pulmonary infection with atelectasis. Our research mainly to investigate the risk factors of post-thoracotomy patients with pulmonary atelectasis and treatment in peri-operation period, in order to reduce the incidence of atelectasis, and increase curative effect, reduce the rate of complications.Methods: We reviewed 162 post-thoracotomy patients diagnosed as pulmonary atelectasis in Department of Thoracic Surgery department in the No.1 hospital attached to Su Zhou University during Jan. 2006 to Jan. 2011, recorded and analyzed their clinical information and clinical treatment。Results: 162 patients were diagnosed as pulmonary atelectasis after post-thoracotomy in Jan. 2006 to Jan. 2011 in our department , the incidence is 3.8%.149 cases were re-expansion, and 13 cases were not re-expansion,the cure is 92%.44 cases (27.2%) were recovered by routine therapy, 56 cases (34.6%) were recovered by bronchofiberscopy ,11 cases (6.8%) were recovered by simple breathing balloon,16 cases (9.9%) were recovered by the treatment of non-invasive breathing machine,17 cases (10.5%) were recovered by the treatment of in-invasive breathing machine, 5 cases (3.1%) were died. 6 patients were recovered in the follow-up of 13 cases discharged with pulmonary atelectasis. except the 5 cases with Restrictive pulmonary atelectasis, 113 cases were not re-expansion by routine therapy. 54 cases were re-expansion by bronchofiberscopy in 72 cases with obstructive pulmonary atelectasis. 27 cases were re-expansion by Ventilator - assisted respiration in 41 cases with non-obstructive and non-restrictive pulmonary pulmonary atelectasis .Conclusion: 1. Pulmonary atelectasis is the common complication after post-thoracotomy , it may cause secondary complications if the treatment is not timely ,early detection,early diagnosis and early treatment is important for the patients with pulmonary atelectasis .2. Restrictive pulmonary atelectasis mostly related to the big blood clots in thoracic cavity and the expansion of the stomach of chest, removing oppressive factors in time is the treatment principles;obstructive pulmonary atelectasis were caused by blood clot and sputum, bronchofiberscopy is the main means of treatment; Ventilator - assisted respiration is the main means of treatmen of non- obstructive and non-restrictive pulmonary atelectasis .