Analysis Of The Incidence Of Hypoxemia Of Lung Cancer Patients With Different Peroperative PaO₂ Levels During Suegery

With the development of lung cancer surgery and anesthetic techniques, cardiopulmonary dysfunction or elderly patients with lung cancer who received more chance of operation. However, the incidence of perioperative complications increases. Blood gas analysis, a relatively objective measure, which can measure kinds of gas partial pressure and electrolytes in the blood, can assess patients tolerated surgery and anesthesia. The majority of patients before surgery PaO2 lower than normal, because of advanced age, smoking, more complications and other factors. A preoperative analysis of the incidence of hypoxemia in patients with lung cancer surgery, whose have different levels of preoperative PaO2, will help to provide a reference for a more accurate assessment of prognosis.This study is to select 204 patients of single lobectomy of lung cancer from March, 2013 to August, 2014 in The Affiliated Hospital of Hebei North university, 139 cases of male, female 65 cases, aged 55~78 years old(62.75 ± 8.49 years). ASA grade Ⅰ~Ⅱ level, BMI ≤30 kg·m-2. According to the preoperative different PaO2 levels,204 lung cancer patients with single lobectomy were divided into 3 groups, Group A(n=25),60 mmHg≤PaO2<65mmHg;Group B(n=46),65mmHg≤PaO2<70mmHg;Group C(n=133; Group C1 and Group C2),PaO2≥70mmHg:Group C1(n=91), PaO2≥70mmHg,when patients were admitted to hospital. Group C2(n=42), PaO2≥70mmHg before surgery,but the patients of this Group had a low PaO2(PaO2<70mmHg)when they were admitted to hospital. In order to compare the incidence of intraoperative hypoxemia of 3 groups patients, some datas were recorded: the blood gas on the first day of admitted to hospital, the day before surgery, the time of 15 min after supine double lung ventilation(DLV), the time of 30 min after one-lung ventilation(OLV), 60 min after OLV, 1 min before two-lung ventilation, 1 min before the end of surgery and extubation, and the time of being cured in ICU. SPSS17.0 statistical software used for statistical processing.Results: ①PaO2 within the three groups had significantly decreased compared with double-lung ventilation after OLV, which is lowest at 30min((P<0.05). PaO2 at 60 min increased than that at 30 min after OLV(P<0.05), PaO2 levels returned to near the level of 15 min after double-lung ventilation before the end of surgery. The level of PaO2 in Group A had a significantly lower than Group B and Group C on the time of 30 min and 60 min after OLV and 1 min before two-lung ventilation and extubation(P<0.05). The level of PaO2 in Group B had a significantly lower than Group C on the time of 30 min and 60 min after OLV and 1 min before two-lung ventilation and extubation(P<0.05). The PaO2 level was no significant differences in Group C1 and Group C2 on every time point(P>0.05). The level of PaCO2, SaO2, SpO2 in the three Groups was no significant differences(P>0.05). ②There are 22 cases of hypoxemia, A group of six patients, group B 9 patients, C1 group of five patients, C2 group 2 patients in 204 cases. Group A and Group B had a significantly higher incidence of intraoperative hypoxemia than that in Group C(P<0.05). There was no significant difference of the incidence of intraoperative hypoxemia in Group A and Group B(P>0.05). ③The treatment time of patients of Group A and B in the ICU were significantly longer than Group C(P<0.05).To a certain extent, preoperative PaO2 levels may predict the occurrence tendency of intraoperative hypoxemia. The patients with preoperative PaO2≥70mmHg can better tolerate thoracotomy.