Evaluation Of Perioperative Blood Gas Analysis In Patients With Thoracic Surgery And Its Clinical Significance

With the development of surgical techniques and diagnostic techniques,the diagnosi s of chest diseases is becoming more and more clear,especially in the lung cancer.Sur gery is generally the first choice of treatment,and the surgical indications are growing.Because the operation time is long,the wound is big,has great influence on the patient's body,and partly needs the general anesthesia with double lumen endotracheal intubati on,which has great influence on the physiological state of the patient.We should stren gthen perioperative monitoring,evaluate patients'operative tolerance before operation,im prove preoperative low lung function,monitor cardiac and pulmonary function actively,prevent and reduce complications,improve prognosis and promote recovery.The application of lung function test and blood gas analysis is an important exami nation to evaluate the surgical tolerance of the Department of thoracic surgery and the observation of perioperative period.In part because of preoperative pulmonary function i n patients with low status,can not match the correct detection of lung function,lung fu nction and operation of subjective and individual differences,it can not reflect the true in some cases,exchange of patient heart and lung function,lung O₂ and CO₂ gas capac ity.Blood gas analysis has the advantages of simple operation,strong objectivity,can b e used for clinical diagnosis of respiratory failure,and clear degree and its types,deter mine whether acid-base disorders,respiratory failure is to guide the clinical treatment an d judging the preoperative pulmonary gas exchange ability,a good evaluation of the op eration tolerance standard.Therefore,blood gas analysis is widely used in clinical practi ce and is gradually becoming a necessary clinical examination for patients in the periop erative period,especially for patients with surgery.Objective:1 To monitor the five indexes of perioperative blood gas analysis,and to analyze the changes in the patients in the operation.2 To study the changes of blood gas analysis during the perioperative period,relationship between oxygen partial pressure and postoperative oxygen pressureand the correspondingrelationship with postoperative complications to provide theoretical basis for guiding patients to tolerate surgical treatment.3 The clinical significance of blood gas analysis to the patient's preoperative tolerance,prognosis and recovery.Methods:1.Case collection:The collection of blood from December to 2017 in our department in 2015 December hospitalized patients samples,a total of 30 cases,including 20 c ases of male,female 10 cases,the age of 54-76 years,the average 65.4 years old,preo perative low pulmonary function?FEV1<70%,VC<80%?^[18]accounted for 16.67%,preoperative positive correction.Other contraindications were not associated with other sur gical procedures?distant metastasis,multiple organ failure,cachexia,etc.?,and for the first time received thoracic surgery.Among the 30 cases,there were 15 cases of esopha geal cancer,9 cases of lung cancer,3 cases of gastric fundus carcinoma,1 cases of chr onic empyema,1 cases of pulmonary hamartoma and 1 cases of malignant pleural meso thelioma.The type of surgery:15 cases of radical resection of the middle and lower esop hageal carcinoma,4 of right upper lobe excision,and the specific situation is shown in the table 1.2.Inspection methods:Preoperative examination within three days after admission,a rterial blood gas analysis in the morning without oxygen under a state of repose,radial arterial blood analysis of open chest examination during operation,postoperative exami nation was done after the operation of the 2h and 6h,1d,2d,3d at around 8a.m.,30minutes before oxygen inhalation?reduce the suction effect of oxygen on the detection results measured by radial artery blood gas analysis?,5 indicators of a total of 7 time points for blood gas analysis?PH,PaO₂,PaCO₂,SaO₂,BE?were obtained by numerical results,during the grouping,before and after the operation were compared at the same time,the statistics of the postoperative complications,and postoperative oxygen partial pressure and reduce the degree of contrast,analysis of the postoperative complications a nd preoperative pulmonary function and postoperative blood pressure correlation analysis of blood gas,patient tolerance,complications and prognosis of recovery It should be r elated.3.Statistical analysis:The numerical value was expressed with mean standard deviat ion?x+s?.Statistical processing was analyzed by SPSS19.0 software.T test was used t o compare the data between groups,and the count data was compared with x² test.The difference of P<0.05 was significant,and it was statistically significant.Result:1 The oxygen partial pressure in the partial pressure of arterial blood gas in 2h-3d after operation is lower than the preoperative monitoring value.2 The value of blood gas analysis of oxygen partial pressure in patients with abno rmal pulmonary function was significantly lower than that of normal pulmonary function before operation.3 The gradual recovery of oxygen partial pressure in blood gas analysis from the beginning of post operation 2d.4 The difference of blood oxygen partial pressure in the perioperative period of di fferent surgical methods is not significant.5 The occurrence of complications after thoracic surgery is directly related to the l ow lung function of the preoperative patients.Conclusion:1 Postoperative blood gas oxygen partial pressure decreased significantly,and decre ased to the lowest in 2d,suggesting that we need to strengthen the function of lung fu nction and promote the early recovery of lung function.2 Preoperative patients with low lung function have a high incidence of postoperati ve complications,as high as 60%.Perioperative period should actively correct lung func tion and reduce the incidence of complications.3 The decrease of oxygen partial pressure during perioperative arterial arterial blood pressure can result in postoperative complications,and the incidence of complications i s even greater when it is less than 85mmHg.4 Effective improvement of preoperative lung function,reduction of intraoperative tr auma,reduce the operation time and adequate postoperative analgesia are important wa ys to reduce postoperative complications of cardiopulmonary function.