Objective. To investigate the changes and influencing factors of early postoperative pulmonary functionof thoracotomy.Methods. Pre-and early postoperative pulmonary function was studied in 64 consecutive cases withopt...Objective. To investigate the changes and influencing factors of early postoperative pulmonary functionof thoracotomy.Methods. Pre-and early postoperative pulmonary function was studied in 64 consecutive cases withoptimal thoracotomy. Pain assessment was done before pulmonary function test, and the chief complaintsof patients were recorded after the procedure. The changing curves of pulmonary function were done andthe differences associated with groups, surgical styles, pain assessment, epidural analgesia, chief com-plaint and preoperative conditions were analyzed.Results. Pulmonary function was severely lowered to about 40% of the base line on the first day,and it was rehabilitated to about 60% of the base line on the eighth day. There was a greater gradienton the recovery curve on the 3rd and 4th days. Epidural analgesia was able to improve pain relaxationand pulmonary function in some degree. Single-factor analysis showed that postoperative pain, postopera-tive day and surgical style were the significant influencing factors for early postoperative pulmonary func-tion. By multiple-factor analysis, preoperative pulmonary function, age and postoperative pain were themain factors, while surgical style had only weak effect on it.Conclusions. Early postoperative pulmonary function is severely impaired by thoracotomy. It rehabili-tate gradually with time. Improvement of preoperative pulmonary function, reducing surgical procedure in-juries, especially injury to respiratory muscle system, and enough postoperative pain relief are the mostimportant means that would reduce pulmonary function impairment and consequently reduce postoperativepulmonary complications.展开更多
Objective:To compare and discuss the GOLD and the diagnostic criteria of severity of COPD adopted by Chinese respiratory academy in 1997 and 2002. Method:The data of pulmonary function of 713 COPD from 1991 to 2001wer...Objective:To compare and discuss the GOLD and the diagnostic criteria of severity of COPD adopted by Chinese respiratory academy in 1997 and 2002. Method:The data of pulmonary function of 713 COPD from 1991 to 2001were reviewed by t - test. All patients were classified as mild ,moderate and severe COPD by the diagnostic criteria of Chinese respiratory academy in 1997 and traditional criteria of pulmonary dysfunction . Some associated problems were discussed. Results:The data and results matched with the two criteria, but data of FEV1/FVC in mild COPD group were different from the diagnostic criteria of GOLD and Chinese respiratory academy in 2002.Conclusion:Chronic bronchitis without airflow limitation is included in the concept of COPD by GOLD and Chinese respiratory academy's diagnostic criteria in 2002,so this part of patients may not be delayed in diagnosis. But FEV1/FVC of some mild COPD patients in early stage may not be lower than 70 %, these COPD patients may be misdiag nosed which is unfavorable to the early intervention and treatment of COPD . In addition , the range of moderate COPD in the criteria of GOLD is too wide to differentiate the severity of the disease,so it is not convenient for guiding the rehabilitative treatment. The functional examination of respiratory muscles will differentiate whether the airflow limitation is from the airway or from the dysfunction of respiratory muscles, and it is irreplaceable for guiding the rehabilitative treatment of respiratory muscles and evaluating the efficiency. We suggest more attention should be paid to these probloms.展开更多
Objective To examine the correlation between the health-related quality of life measured by the St.George's Respiratory Questionnaire(SGRQ) and the commonly used physiological measures in lymphangioleiomyomatosis(...Objective To examine the correlation between the health-related quality of life measured by the St.George's Respiratory Questionnaire(SGRQ) and the commonly used physiological measures in lymphangioleiomyomatosis(LAM).Methods This study retrospectively analyzed the SGRQ scores and other measures(the Borg scale of breathlessness at rest,6-minute walking distance,blood oxygen levels,and pulmonary function) of patients diagnosed and confirmed with LAM.Altogether 38 patients between June 2007 and November 2009 were included.Results The mean values of the SGRQ three components(symptoms,activity,and impacts) and total scores in the LAM patients were 46.95±28.90,58.47±25.41,47.89±29.66,and 51.11±26.35,respectively.The SGRQ total or component scores were correlated well with the Borg scale of breathlessness,6-minute walking distance,partial pressure of oxygen in arterial blood,spirometry and diffusion capacity of lung.There were poor correlations between SGRQ score and residual volume or total lung capacity.In our preliminary observation,sirolimus improved the SGRQ total and three component scores and the Borg scale of breathlessness significantly after 101-200 days of treatment(n=6).Conclusions The SGRQ score in LAM is correlated well with physiological measures(Borg scale of breathlessness,6-minute walking distance,blood oxygen levels,and pulmonary function tests).The SGRQ could therefore be recommended in baseline and follow-up evaluation of patients with LAM.Treatment with sirolimus,an inhibitor of mammalian target of rapamycin,may improve the quality of life and patient's perception of breathlessness in LAM.展开更多
文摘Objective. To investigate the changes and influencing factors of early postoperative pulmonary functionof thoracotomy.Methods. Pre-and early postoperative pulmonary function was studied in 64 consecutive cases withoptimal thoracotomy. Pain assessment was done before pulmonary function test, and the chief complaintsof patients were recorded after the procedure. The changing curves of pulmonary function were done andthe differences associated with groups, surgical styles, pain assessment, epidural analgesia, chief com-plaint and preoperative conditions were analyzed.Results. Pulmonary function was severely lowered to about 40% of the base line on the first day,and it was rehabilitated to about 60% of the base line on the eighth day. There was a greater gradienton the recovery curve on the 3rd and 4th days. Epidural analgesia was able to improve pain relaxationand pulmonary function in some degree. Single-factor analysis showed that postoperative pain, postopera-tive day and surgical style were the significant influencing factors for early postoperative pulmonary func-tion. By multiple-factor analysis, preoperative pulmonary function, age and postoperative pain were themain factors, while surgical style had only weak effect on it.Conclusions. Early postoperative pulmonary function is severely impaired by thoracotomy. It rehabili-tate gradually with time. Improvement of preoperative pulmonary function, reducing surgical procedure in-juries, especially injury to respiratory muscle system, and enough postoperative pain relief are the mostimportant means that would reduce pulmonary function impairment and consequently reduce postoperativepulmonary complications.
文摘Objective:To compare and discuss the GOLD and the diagnostic criteria of severity of COPD adopted by Chinese respiratory academy in 1997 and 2002. Method:The data of pulmonary function of 713 COPD from 1991 to 2001were reviewed by t - test. All patients were classified as mild ,moderate and severe COPD by the diagnostic criteria of Chinese respiratory academy in 1997 and traditional criteria of pulmonary dysfunction . Some associated problems were discussed. Results:The data and results matched with the two criteria, but data of FEV1/FVC in mild COPD group were different from the diagnostic criteria of GOLD and Chinese respiratory academy in 2002.Conclusion:Chronic bronchitis without airflow limitation is included in the concept of COPD by GOLD and Chinese respiratory academy's diagnostic criteria in 2002,so this part of patients may not be delayed in diagnosis. But FEV1/FVC of some mild COPD patients in early stage may not be lower than 70 %, these COPD patients may be misdiag nosed which is unfavorable to the early intervention and treatment of COPD . In addition , the range of moderate COPD in the criteria of GOLD is too wide to differentiate the severity of the disease,so it is not convenient for guiding the rehabilitative treatment. The functional examination of respiratory muscles will differentiate whether the airflow limitation is from the airway or from the dysfunction of respiratory muscles, and it is irreplaceable for guiding the rehabilitative treatment of respiratory muscles and evaluating the efficiency. We suggest more attention should be paid to these probloms.
基金Supported by National Basic Research Program of China (973 Program) (2009CB522106)
文摘Objective To examine the correlation between the health-related quality of life measured by the St.George's Respiratory Questionnaire(SGRQ) and the commonly used physiological measures in lymphangioleiomyomatosis(LAM).Methods This study retrospectively analyzed the SGRQ scores and other measures(the Borg scale of breathlessness at rest,6-minute walking distance,blood oxygen levels,and pulmonary function) of patients diagnosed and confirmed with LAM.Altogether 38 patients between June 2007 and November 2009 were included.Results The mean values of the SGRQ three components(symptoms,activity,and impacts) and total scores in the LAM patients were 46.95±28.90,58.47±25.41,47.89±29.66,and 51.11±26.35,respectively.The SGRQ total or component scores were correlated well with the Borg scale of breathlessness,6-minute walking distance,partial pressure of oxygen in arterial blood,spirometry and diffusion capacity of lung.There were poor correlations between SGRQ score and residual volume or total lung capacity.In our preliminary observation,sirolimus improved the SGRQ total and three component scores and the Borg scale of breathlessness significantly after 101-200 days of treatment(n=6).Conclusions The SGRQ score in LAM is correlated well with physiological measures(Borg scale of breathlessness,6-minute walking distance,blood oxygen levels,and pulmonary function tests).The SGRQ could therefore be recommended in baseline and follow-up evaluation of patients with LAM.Treatment with sirolimus,an inhibitor of mammalian target of rapamycin,may improve the quality of life and patient's perception of breathlessness in LAM.
