| Objective The purpose of this study was to investigate the related factors and possible mechanisms of metabolic acidosis in patients undergoing thoracoscopic lung surgery.Methods The study selected 342 patients admitted to the general thoracic surgery from January 2017 to December 2018 for concurrent thoracoscopic operation of pulmonary nodules or lung occupancy.According to the arterial blood gas analysis results of the day after operation,the cases of different surgical methods were divided into acidosis group and non-acidosis group.The results were obtained by comparing the statistical differences between the two groups.The results were obtained by comparing the differences between the two groups according to whether metabolic acidosis occurred in different surgical methods in different years.The statistical clinical data include: gender,age,weight,ASA classification,postoperative blood gas analysis values(BE,HCO3-,Lac),intraoperative urine volume,intraoperative percutaneous oxygen saturation,operation time,intraoperative fluid input.Total amount and type of liquid,the amount of bleeding during surgery,the length of hospitalization after surgery,and the incidence of postoperative complications.Results 1.The study included 248 cases of pulmonary lobectomy,including 162(65.32%)cases of acidosis and 86(36.68%)cases of no acidosis.Comparison of preoperative clinical data(sex,age,weight,ASA classification)in patients with pulmonary lobectomy was not statistically significant(P >0.05)There was no statistical significance in comparing the two groups of urine volume,the amount of urine per kilogram per hour,and the percutaneous oxygen saturation during surgery(P >0.05)It is statistically significant to compare the two groups of surgery time,intraoperative hemorrhage,total intraoperative fluid input,hourly fluid input per kilogram,average post-operative hospitalization day,and postoperative complication incidence(P <0.05);2.The study included 94 cases of lung cuneiform resection,40(42.55%)cases of acidosis after surgery,and 54(57.45%)cases of acidosis.Comparison of preoperative clinical data(sex,age,weight,ASA classification)of patients with pneumonidectomy with no statistical significance(P >0.05)There was no statistical significance in comparing the two groups of surgery time,intraoperative hemorrhage,urine volume,urine volume per kilogram per hour,and intraoperative percutaneous oxygen saturation(P >0.05)It is statistically significant to compare the total amount of liquid input during surgery,the amount of liquid input per kilogram per hour,the average length of hospitalization after surgery,and the incidence of postoperative complications in the two groups(P <0.05);3.Comparing the types of colloids imported during surgery in different surgical types of metabolic acidosis and non-metabolic acidosis groups,the results showed no statistical significance(P >0.05);4.The study included 123 cases of pulmonary lobectomy in 2017,including 92(74.80%)cases of metabolic acidosis and 125 cases of pulmonary lobectomy in 2018.Among them,70(56%)patients with metabolic acidosis were found to have statistical significance compared with the incidence of metabolic acidosis after lung lobectomy in 2017 and 2018,the operation time,and the amount of liquid input per kilogram per hour(P <0.05),There was no statistically significant difference in intraoperative bleeding between the two groups(P >0.05);5.The study included 43 cases of lung cuneectomy in 2017,including 16(37.20%)cases of metabolic acidosis and 51 cases of 2018 cases of lung cuneectomy,of which 24(47.06%)cases of metabolic acidosis occurred.The incidence,operation time and bleeding volume of postoperative metabolic acidosis were not statistically significant in patients undergoing lung cuneecectomy in 2017 and 2018(P >0.05)The results of comparing the two groups with the amount of liquid per kilogram per hour were statistically significant.Conclusion 1.The occurrence of metabolic acidosis in patients after thoracoscopic surgery is strongly related to the length of operation time,the amount of intraoperative bleeding and the amount of intraoperative fluid input.The longer the operation time,the more intraoperative bleeding and the more intraoperative fluid input,the more likely the patients to develop metabolic acidosis after thoracoscopic surgery.2.Metabolic acidosis occurs in patients after thoracoscopic surgery.Toxicity significantly increased the average hospitalization days and the incidence of complications after surgery.3.Metabolic acidosis after surgery was not related to the type of colloids injected during the operation. |
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