The analysis of changes and influencing factors of early postthoracotomy pulmonary function.
OBJECTIVE
To investigate the changes and influencing factors of early postoperative pulmonary function of thoracotomy.


METHODS
Pre- and early postoperative pulmonary function was studied in 64 consecutive cases with optimal thoracotomy. Pain assessment was done before pulmonary function test, and the chief complaints of patients were recorded after the procedure. The changing curves of pulmonary function were done and the differences associated with groups, surgical styles, pain assessment, epidural analgesia, chief complaint 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 gradient on the recovery curve on the 3rd and 4th days. Epidural analgesia was able to improve pain relaxation and pulmonary function in some degree. Single-factor analysis showed that postoperative pain, postoperative day and surgical style were the significant influencing factors for early postoperative pulmonary function. By multiple-factor analysis, preoperative pulmonary function, age and postoperative pain were the main factors, while surgical style had only weak effect on it.


CONCLUSIONS
Early postoperative pulmonary function is severely impaired by thoracotomy. It rehabilitate gradually with time. Improvement of preoperative pulmonary function, reducing surgical procedure injuries, especially injury to respiratory muscle system, and enough postoperative pain relief are the most important means that would reduce pulmonary function impairment and consequently reduce postoperative pulmonary complications.
Yushang
Cui
C
Department of Thoracic Surgery, PUMC Hospital, CAMS & PUMC, Beijing 100730.
Zhiyong
Zhang
Z
Xiequn
Xu
X
D000328:Adult; D000367:Age Factors; D000368:Aged; D015360:Analgesia, Epidural; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D011184:Postoperative Period; D012129:Respiratory Function Tests; D013908:Thoracotomy / Q000009:adverse effects; D014797:Vital Capacity