Impact Of Heavy Smoking And Surgical Methods On PPC In Senile Patients

Purpose:To observe the effects of heavy smoking and surgical methods on pulmonary function in senile patients, and to explore the impacts of the two factors on the incidence of postoperative pulmonary complications (PPC) in senile patients.Methods:From January2011to January2012in Shandong provincial hospital,70selected senile patients with esophageal or gastric cancer were admitted to ICU after surgical treatments. They were divided into four groups according to the heavy smoking history and different surgical operations. Recorded the statistical data such as preoperative lung function, preoperative or postoperative PaO2and PaCO2, postoperative length of stay in ICU, the incidence of postoperative pulmonary complications, and then carry out statistical processing and analysis.Results:Parts of preoperative lung function indicators in severe smokers, such as FEV1%, FEV1/FVC, MVV%, MEF50%, MEF25%, MMEF%and DLCO%, were significantly lower than those in non-smokers (P<0.01). As for FVC%, PEF%, MEF75%, RV/TLC, differences between two groups have not yet reached significant levels (P>0.05). Preoperative PaO2in heavy smokers was significantly lower than that in non-smokers, while PaCO2in heavy smokers was significantly higher (P<0.01). In thoracic surgery groups, whether heavy smoking or not, postoperative PaO2and PaCO2decreased significantly than those in epigastric surgery groups (P<0.05), and postoperative ICU stay was significantly prolonged (P<0.01), and the incidence of postoperative pulmonary complications was also increased (P<0.05). In heavy smokers after thoracic or epigastric surgery, postoperative ICU stay was significantly prolonged than that in non-smokers (P<0.01), and the incidence of postoperative pulmonary complications was also significantly increased (P<0.05).Conclusions:Heavy smoking in senile patients can cause pulmonary ventilation and reserve function partially damaged. But small airway function and pulmonary diffusion capacity are severely damaged, with PaO2decreased and PaCO2increased. After thoracic surgery, respiratory function will be significantly exacerbated in senile patients, resulting in an increased incidence of postoperative pulmonary complications. And thoracic surgery could also prolong the postoperative ICU stay. Heavy smoking as another important risk factor, can also lead to the higher risk of postoperative pulmonary complications, and longer postoperative ICU stay.