Objective To investigate the clinical significance of low dose corticosteroid applied in early period after lung volume reduction surgery(LVRS). Methods From Apr. 2001 to Mar. 2004, 27 patients with chronic obstructive pulmonary disease were undergone video-assisted unilateral LVRS assisted with mini-incision in our department were retrospectively reviewed. According to whether dispensed with postoperative corticosteroid or not, patients were divided into corticosteroid group and non-corticosteroid group. Corticosteroid group received dexamethasone 10mg iv tid for 3 days and then declined to prednisone 5mg qd for 7 days. Both groups were measured and compared the quantity of thoracic drainage flow, duration of chest tube drainage, the time of air leaks and fever, and so on. At same time, blood gas analysis and blood routine test were performed at 1, 3, 7 and 30 d after operation. Results Corticosteroid and non-corticosteroid groups had no statistically differences in the air leaks time (P 〉 0.05), but the quantity of thoracic drainage flow of corticosteroid group was lower than that of non-corticosteroid group evidently (700±210ml vs. 950±150ml, P = 0.001). There was significant difference in average duration of chest tube drainage between both groups (9±3 d vs. 12±2 d, P = 0. 05). Compared with non-corticosteroidgroup, PaO2 of corticosteroid group was higher at 1, 3d after operation (P〈0.05). The amount of blood leukocyte of corticosteroid group was lower than that of non-corticosteroid group at 3, 7d after operation, there was no statistically significant in two groups (P 〉 0. 05). At early period after surgery, both groups had no significant infection and death patient. Conclusion The low dose corticosteroid applied in early period after LVRS for short time(10 days in this research) could shorten the duration of chest tube drainage, decrease the quantity of thoracic drainage flow and the extent of inflammation in pleural cavity. In the mean time, this treatment does not increase the occurrence of significant complications during the early postoperative period, and there is no negative influence to the blood gas analysis.
Citation: HOU Shengcai,MIAO Jinbai,HU Bin,et al .. Clinical Study of Low Dose Corticosteroid Applied in Early Period after Lung Volume Reduction Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2006, 13(5): 318-321. doi: Copy