Study On Changes Of Lung Function And Blood Gas In Patients Undergoing Bilateral Pulmonary Nodules Surgery At The Same Period And At Different Stages

Objective: The determination of the indexes of lung function and blood gas in patients with bilateral multiple primary pulmonary nodules before and after bilateral pulmonary surgery operation at the same time in 3 months,and the determination of the indexes of lung function and blood gas in patients with bilateral multiple primary pulmonary nodules before and after staging pulmonary surgery in 3 months.The changes of the indexes of lung function and blood gas in patients were compared under the two surgical methods,which make different operation schemes for different patients.Methods: A total of 120 patients between 30 and 60 years old with bilateral multiple primary pulmonary nodules and consideration to early stage lung cancer were selected as the study subjects in the department of thoracic surgery of the second hospital of Dalian Medical University.According to the surgical methods,they were divided into 60 patients undergoing thoracoscopic simultaneous bilateral pulmonary resection(group A),with A male to female ratio of 22:38;60 patients undergoing thoracoscopic staging bilateral pulmonary resection(group B),with B male to female ratio of 24:36.Among them,the method of the simultaneous operation group include simultaneous resection of the apical posterior segment of the upper lobe of the left lung and the dorsal segment of the lower lobe of the right lung or the posterior segment of the upper right lung lobe or a wedge resection of the right lung in 30 cases,and simultaneous resection of the dorsal segment of the left lower lobe or the lingual segment of the left upper lobe or a wedge resection of the left lung and the right upper lobe in 30 cases.The method of the staging operation group was the same as that of the simultaneous operation group,successive resection of the apical posterior segment of the upper lobe of the left lung and the dorsal segment of the lower lobe of the right lung or the posterior segment of the upper right lung lobe or a wedge resection of the right lung in 30 cases,and successive resection of the dorsal segment of the left lower lobe or the lingual segment of the left upper lobe or a wedge resection of the left lung and the right upper lobe in 30 cases,in order to ensure that two groups have the same range of lung tissue removed.The changes of lung function and blood gas indexes including FVC%?FEV1%?MVV?PO2 before and after surgery in two groups were compared.The indexes of lung function and blood gas in the staging operation group were measured 3 months later of the second time of the operation.Statistical analysis was performed with SPSS 20.0.Results:(1)Lung function and blood indexes,FVC%?FEV1%?MVV and PO2 decreased in patients who underwent bilateral lung resection at the same time and staging time 3 months after the surgery.The decreased rates of FVC%?FEV1%?MVV and PO2 in pulmonary function and blood gas indexes of patients with bilateral pulmonary resection at the same time were significantly higher in the contemporaneous group than in the staging surgery group,the difference was statistically significant(P<0.05).(2)Under different stages of the operation,the changes of indexes in lung function and blood gas at 3 months after the operation are related to age.The older in patients,the greater decrease rate of lung function blood gas indexes FVC% ? FEV1% ? MVV and PO2 at 3 months after the operation,especially patients above 50 years old,the difference was statistically significant(P<0.05).Conclusion: For simultaneous resection of bilateral pulmonary nodules,it is suitable for patients under 50 years old without underlying disease and excellent lung function or blood gas.Its advantage is to solve bilateral lesions at one time,so as to benefit the patients most psychologically and economically.The staging resection of bilateral pulmonary nodules is suitable for the elderly over 50 years old,patients with poor lung function and who cannot tolerate the operation at the same time,and its advantage is to reduce the risk of surgery and postoperative complications,increase the tolerance of patients,reduce pain and facilitate postoperative recovery.