Evaluation of Treating Patients Undergoing Open Chest Surgery with Airway Management Drugs and Moderate or Severe COPD_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUYu , ZHANGMei , YUANLei , HUFeng-biao ,  ZOUZhi-qiang

Department of Toracic Surgery, General Hospital of Jinan Military Area, Jinan 250031, P. R. China;

Corresponding author：

ZOUZhi-qiang, Email: zdyddy2000@tom.com

Keywords：

Open chest surgery; Chronic obstructive pulmonary disease; Airway management drugs; Perioperative period

DOI：

10.7507/1007-4848.20150276

Video：

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Objective To evaluate the effect of airway management drugs on the respiratory function and postoperative recovery of patients who had moderate or severe chronic obstructive pulmonary diseases(COPD) undergoing an open chest surgery. Method There were a total of 22 patients suffering from both lung cancer, esophageal cancer or gastroesophageal junction carcinoma and moderate to severe COPD(of which there were 16 males and 6 females; accepting traditional operation 5 cases and minimally-invasive operation 17 cases; lung cancer 16 cases, esophageal cancer 4 cases and gastroesophageal junction carcinoma 2 cases as the observation group). To statistic the respiratory function and arterial blood gas analysis before and after treating with airway management drugs. And compare the postoperative pulmonary complications(PPCs) and hospital-stay with 50 patients who have no COPD(of which there were 34 males and 16 females; accepting traditional operation 17 cases and minimally-invasive operation 33 cases; lung cancer 35 cases, esophageal cancer 11 cases and gastroesophageal junction carcinoma 4 cases as the control group). Result There was a statistical difference of forced expiratory volume in one second(FEV₁), forced vital capacity(FVC) and maximal voluntary ventilation(MVV) after the above treatment by 7 to 10 days and comparing with prior treatment(P<0.05). Partial pressure of oxygen(PaO₂) increased with no statistical difference(P>0.05) while PaCO₂ decreased with a statistical difference(P<0.05）. Comparing with patients without COPD, the incidences of PPCs and postoperative hospital stay were of no statistical difference(P>0.05). Conclusion Patients with moderate or severe COPD with airway management drugs(antibiotics,glucocorticoids, bronchodilators and phlegm dissolving agent) in perioperative period could improve the respiratory function and operation tolerance effectively, reduce the incidence of PPCs and shorten postoperative hospital stay.

Citation： LIUYu, ZHANGMei, YUANLei, HUFeng-biao, ZOUZhi-qiang. Evaluation of Treating Patients Undergoing Open Chest Surgery with Airway Management Drugs and Moderate or Severe COPD. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(12): 1104-1108. doi: 10.7507/1007-4848.20150276 Copy

1.	Zhong N, Wang C, Yao W, et al. Prevalence of chronic obstructive pulmonary disease in China:a large population-based survey. Am J Respir Crit Care Med, 2007, 176(8):753-760.
2.	Loganathan RS, Stover DE, Shi W, et al. Prevalence of COPD in women compared to men around the time of diagnosis of primary lung cancer. Chest, 2006, 129(5):1305-1312.
3.	Benzo R, Kelley GA, Recchi L, et al. Complications of lung resection and exercise capacity:a meta-analysis. Respir Med, 2007, 101(8):1790-1797.
4.	支修益. 胸外科围手术期气道管理专家共识(2012 年版).中国胸心血管外科临床杂志, 2013, 20(3):251-255.
5.	杨为贵, 杨春, 聂文双, 等. 肺功能不全食管癌患者的围手术期处理. 中国胸心血管外科临床杂志, 2011, 18(3):273-275.
6.	全志伟. 肺功能测定对腹部手术风险及术后并发症的评估作用. 中国实用外科杂志, 2004, 24(3):142-144.
7.	Wong DH, Weber EC, Schell MJ, et al. Factors associated with postoperative pulmonary complications in patients with severe chronic obstructive pulmonary disease. Anesth Analg, 1995, 80(2):276-284.
8.	崔玉尚, 张志庸, 阿伊都·阿布都热伊木. 开胸术后早期肺功能的变化规律及影响因素分析. 中华外科杂志, 2003, 41(12):909-912.
9.	Miyoshi S, Yoshimasu T, Hirai T, et al. Exercise capacity of thoracotomy patients in the early postoperative period. Chest, 2000, 118(2):384-390.
10.	矫文捷, 王天佑, 龚民, 等. 非小细胞肺癌并COPD患者术后肺部并发症分析. 中华临床医药杂志, 2004, 5(2):15-17.
11.	俞婷婷, 谢德荣, 杜黎明, 等. 普米克令舒联合可必特雾化吸入改善肺癌合并重度COPD患者术前肺功能及扩大手术适应症研究. 临床肺科杂志, 2013, 18(5):793-795.
12.	唐建新, 张贻秋, 向志, 等. 长期吸入糖皮质激素联合异丙托溴铵治疗COPD疗效观察. 临床肺科杂志, 2008, 13(1):86.
13.	杨鲁民, 矫文捷, 陈岩, 等. 中重度慢性阻塞性肺疾病合并肺癌围手术期肺功能的保护. 中国肿瘤外科杂志, 2012, 4(2):67-71.
14.	中华医学会儿科学分会呼吸学组《中华儿科杂志》编辑委员会. 儿童支气管哮喘诊断与防治指南. 中华儿科杂志, 2008, 46(10):745-753.
15.	柳涛, 蔡柏蔷. 慢性阻塞性肺疾病诊断、处理和预防全球策略(2011 年修订版)介绍. 中国呼吸与危重监护杂志, 2012, 11(1):1-12.
16.	王天佑. 胸外科围手术期肺保护的专家共识. 中华外科杂志, 2009, 47(18):1361-1364.
17.	W ilson S J, Wallin A, Sand strom T, et al. Effect of budesonide and formoterol on NF-kappaB, adhesion molecules, and cytokines in asthma. Am J Respir Critare Med, 2001, 164(6):1047-1052.
18.	Koizumi K, Haraguchi S, Hirata T, et al. Surgery treatment for lung cancer patients with poor pulmonary function. Ann Thorac Cardiovasc, 2005, 11(2):87-92.
19.	Mei J, Liu LX, Tang ML, et al. Airway bacterial colonization in patients with non-small cell lung cancer and the alterations during the perioperative period. J Thorac Disease, 2014, 6(9):2072-1439.
20.	Stetinova V, Herout V, Kvetina J. In vitro and in vivo antioxidant activity of ambroxol. Clin Exp Med, 2004, 4(3):152-158.
21.	Beeh KM, Beier J, Esperester A, et al. Antiinflammatory properties of ambroxol. Eur J Med Res, 2008, 13(12):557-562.
22.	张国清, 朱光发. 大剂量沐舒坦防治呼吸窘迫综合征的研究进展. 国外医学:呼吸系统分册, 2003, 23(2):76-78.
23.	Wunderer H, Morgenroth K, Weis G. The cleaning system of the airways:physiology, pathophysiology and effects of ambroxol. Med Monatsschr Pharm, 2009, 32(2):42-47.
24.	Refai M, Brunelli A, Xiumé F, et al. Short-term perioperative treatment with ambroxol reduces pulmonary complications and hospital costs after pulmonary lobectomy:a randomized trial. Eur J Cardiothorac Surg, 2009, 35(3):469-473.
25.	支修益. 加强胸外科围手术期气道管理, 降低肺癌合并慢性阻塞性肺病患者并发症. 中国胸心血管外科临床杂志, 2014, 21(5):575-576.

1. Zhong N, Wang C, Yao W, et al. Prevalence of chronic obstructive pulmonary disease in China:a large population-based survey. Am J Respir Crit Care Med, 2007, 176(8):753-760.
2. Loganathan RS, Stover DE, Shi W, et al. Prevalence of COPD in women compared to men around the time of diagnosis of primary lung cancer. Chest, 2006, 129(5):1305-1312.
3. Benzo R, Kelley GA, Recchi L, et al. Complications of lung resection and exercise capacity:a meta-analysis. Respir Med, 2007, 101(8):1790-1797.
4. 支修益. 胸外科围手术期气道管理专家共识(2012 年版).中国胸心血管外科临床杂志, 2013, 20(3):251-255.
5. 杨为贵, 杨春, 聂文双, 等. 肺功能不全食管癌患者的围手术期处理. 中国胸心血管外科临床杂志, 2011, 18(3):273-275.
6. 全志伟. 肺功能测定对腹部手术风险及术后并发症的评估作用. 中国实用外科杂志, 2004, 24(3):142-144.
7. Wong DH, Weber EC, Schell MJ, et al. Factors associated with postoperative pulmonary complications in patients with severe chronic obstructive pulmonary disease. Anesth Analg, 1995, 80(2):276-284.
8. 崔玉尚, 张志庸, 阿伊都·阿布都热伊木. 开胸术后早期肺功能的变化规律及影响因素分析. 中华外科杂志, 2003, 41(12):909-912.
9. Miyoshi S, Yoshimasu T, Hirai T, et al. Exercise capacity of thoracotomy patients in the early postoperative period. Chest, 2000, 118(2):384-390.
10. 矫文捷, 王天佑, 龚民, 等. 非小细胞肺癌并COPD患者术后肺部并发症分析. 中华临床医药杂志, 2004, 5(2):15-17.
11. 俞婷婷, 谢德荣, 杜黎明, 等. 普米克令舒联合可必特雾化吸入改善肺癌合并重度COPD患者术前肺功能及扩大手术适应症研究. 临床肺科杂志, 2013, 18(5):793-795.
12. 唐建新, 张贻秋, 向志, 等. 长期吸入糖皮质激素联合异丙托溴铵治疗COPD疗效观察. 临床肺科杂志, 2008, 13(1):86.
13. 杨鲁民, 矫文捷, 陈岩, 等. 中重度慢性阻塞性肺疾病合并肺癌围手术期肺功能的保护. 中国肿瘤外科杂志, 2012, 4(2):67-71.
14. 中华医学会儿科学分会呼吸学组《中华儿科杂志》编辑委员会. 儿童支气管哮喘诊断与防治指南. 中华儿科杂志, 2008, 46(10):745-753.
15. 柳涛, 蔡柏蔷. 慢性阻塞性肺疾病诊断、处理和预防全球策略(2011 年修订版)介绍. 中国呼吸与危重监护杂志, 2012, 11(1):1-12.
16. 王天佑. 胸外科围手术期肺保护的专家共识. 中华外科杂志, 2009, 47(18):1361-1364.
17. W ilson S J, Wallin A, Sand strom T, et al. Effect of budesonide and formoterol on NF-kappaB, adhesion molecules, and cytokines in asthma. Am J Respir Critare Med, 2001, 164(6):1047-1052.
18. Koizumi K, Haraguchi S, Hirata T, et al. Surgery treatment for lung cancer patients with poor pulmonary function. Ann Thorac Cardiovasc, 2005, 11(2):87-92.
19. Mei J, Liu LX, Tang ML, et al. Airway bacterial colonization in patients with non-small cell lung cancer and the alterations during the perioperative period. J Thorac Disease, 2014, 6(9):2072-1439.
20. Stetinova V, Herout V, Kvetina J. In vitro and in vivo antioxidant activity of ambroxol. Clin Exp Med, 2004, 4(3):152-158.
21. Beeh KM, Beier J, Esperester A, et al. Antiinflammatory properties of ambroxol. Eur J Med Res, 2008, 13(12):557-562.
22. 张国清, 朱光发. 大剂量沐舒坦防治呼吸窘迫综合征的研究进展. 国外医学:呼吸系统分册, 2003, 23(2):76-78.
23. Wunderer H, Morgenroth K, Weis G. The cleaning system of the airways:physiology, pathophysiology and effects of ambroxol. Med Monatsschr Pharm, 2009, 32(2):42-47.
24. Refai M, Brunelli A, Xiumé F, et al. Short-term perioperative treatment with ambroxol reduces pulmonary complications and hospital costs after pulmonary lobectomy:a randomized trial. Eur J Cardiothorac Surg, 2009, 35(3):469-473.
25. 支修益. 加强胸外科围手术期气道管理, 降低肺癌合并慢性阻塞性肺病患者并发症. 中国胸心血管外科临床杂志, 2014, 21(5):575-576.

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Evaluation of Treating Patients Undergoing Open Chest Surgery with Airway Management Drugs and Moderate or Severe COPD

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