Objective To explore the effect of systematic respiratory training on lung function in patients with mild to moderate traumatic brain injury. Methods A total of 60 patients with craniocerebral injury who received conservative treatment from January 2015 to June 2017 were selected. These patients were randomly divided into two groups: breathing training group for systematic breathing training and conventional treatment group for conventional rehabilitation training. Pulmonary infection, length of hospital stay, lung function determination, vital capacity, percentage of maximal ventilation, patient’s oxygen saturation, arterial partial pressure of oxygen, peak airway pressure, airway resistance, and respiratory mechanics were observed. Results The pulmonary infection rate and the length of hospital stay in the respiratory training group were 10.0% and (8.17±0.99) days, respectively, which were significantly lower than those in the conventional treatment group [33.3% and (12.67±0.99) days, respectively]; the differences between the two groups were statistically significant (P<0.05). At the same time, pulmonary function, oxygen saturation, arterial oxygen tension, and respiratory mechanics were all better in the breathing training group than those in the conventional treatment group, the differences between the two groups were statistically significant (P<0.05). Conclusion Breathing training can significantly improve the recovery of lung function in patients with mild to moderate traumatic brain injury, reduce the incidence of complications and effectively improve the prognosis.
【Abstract】 Objective To observe the effects of scoliosis on pulmonary function. Methods 31 cases of scoliosis were included and underwent pulmonary function test ( PFT) . The cases were divided into an adolescent group ( 16 cases) and an adult group ( 15 cases) according to age. Predicted value was used as a reference to assess various PFT parameters. Results In both groups, forced expiratory volume in one second, forced vital capacity, and pulmonary diffusion decreased. In the adolescent group, residual volume,functional residual volume, and total lung capacity decreased. In the adult group, vital capacity and maximal voluntary ventilation decreased, the ratio of forced expiratory volume in one second to forced vital capacity decreased, and resonance frequencies increased significantly compared with the adolescent group ( P lt; 0. 05) . Conclusion Scoliosis may lead to restrictive ventilation defect, which is mainly lung volume reduction in adolescent patients and more severe in adult patients.
Abstract: Objective To investigate the clinical effect of using zerobalanced ultrafiltration on postoperative lung function of coronary artery bypass grafting (CABG) patients under cardiopulmonary bypass (CPB). Methods Forty coronary artery bypass grafting patients in the First Affiliated Hospital of China Medical University from June 2006 to December 2008 were enrolled in this study, and were divided into two groups based on different ultrafiltration procedures. Patients in the experimental group (n=20), 14 males and 6 females, with an age of 65.43±8.31 years, underwent zerobalanced ultrafiltration and conventional ultrafiltration after CPB was carried out. Patients in the control group (n=20), 15 males and 5 females, with an age of 66.51±7.62 years, only underwent conventional ultrafiltration after temperature restoration. Preoperative pulmonary function and arterial blood gas were tested routinely. Airway resistance (Raw), oxygenation index (OI) and alveolar arterial oxygen difference ［P(Aa)O2］ were measured at the following points: before CPB, at the end of CPB, 6 hours, and 12 hours after operation. Postoperative mechanical ventilation time was also recorded. Results There was no significantly statistical difference between the two groups of patients in pulmonary function and arterial blood gas indexes before operation, and Raw, OI and P(Aa)O2 before CPB (Pgt;0.05). Nevertheless, at the points of 6 hours and 12 hours after operation, Raw ［2.22±0.31 cm H2O/(L·s) vs. 2.94±0.42 cm H2O/(L·s), F=0.061, Plt;0.05; 1.89±0.51 cm H2O/(L·s) vs. 2.52±0.29 cm H2O/(L·s), F=0.096, Plt;0.05］ and P(Aa)O2 (86.74±7.63 mm Hg vs. 111.66±7.49 mm Hg, F=0.036, Plt;0.05; 74.82±5.67 mm Hg vs. 95.23±6.78 mm Hg, F=0.059, Plt;0.05) of patients in the experimental group were significantly lower than those of patients in the control group. At the same points, OI of patients in the experimental group was significantly higher than that of patients in the control group (384.33±30.67 vs. 324.63±31.22, F=0.033, Plt;0.05; 342.24±23.43 vs. 293.67±25.44, F=0.047, Plt;005). Ventilator support time of the experimental group was shorter than the control group (15.44±3.93 h vs. 20.68±5.77 h,Plt;0.05). Conclusion Zerobalanced ultrafiltration can improve pulmonary function after coronary artery bypass grafting and shorten postoperative mechanical ventilation time.
Objective To evaluate the effect of cardiopulmonary bypass （CPB） on pulmonary function in infants with variable pulmonary arterial pressure resulting from congenital ventricular septal defect （VSD）. Methods Twenty infants with VSD underwent corrective surgery were divided into pulmonary hypertension group （n= 10） and non-pulmonary hypertension group （n= 10） according to with pulmonary hypertension or not. Pulmonary function was measured before CPB , 3h,6h,9h,12h,15h,18h,21h, and 24h after CPB and duration for mechanical ventilation and cardiac intensive care unit stay were recorded. Results Pulmonary function parameters before CPB in nonpulmonary hypertension group were superior to those in pulmonary hypertension group （P〈0.01）, and pulmonary function parameters after CPB deteriorated than those before CPB （P〈0.05）, especially 9h,12h and 15h after CPB （P〈0.01）. Compared to pulmonary function parameters before CPB, pulmonary function parameters of pulmonary hypertension group at 3h after CPB were improved （P〉0.05）, but they deteriorated at 9h,12h and 15h after CPB （P〈0. 05）. Pulmonary function parameters at 21h and 24h after CPB was recoverd to those before CPB in two groups. Conclusions Although exposure to CPB affects pulmonary function after VSD repair in infants, the benefits of the surgical correction to patients with pulmonary hypertension outweigh the negative effects of CPB on pulmonary function. Improvement of cardiac function can avoid the nadir of pulmonary function decreasing. The infants with pulmonary hypertension will be weaned off from mechanical ventilator as soon as possible, if hemodynamics is stable, without the responsive pulmonary hypertension or pulmonary hypertension crisis after operation.
Objective To establish amedical reference for adult pulmonary function parameters and a normal FEV1 /FVC% pred in population of Shanghai. Methods Subjects who underwent routine physical examination were initially screened and those who met enrollment criteria with age over 18 years old were required to underwent pulmonary function tests in Zhongshan Hospital from June 2009 to February 2010. After screening of 450 subjects, a total of 240 subjects with normal pulmonary function and 120 subjects with mild small airway abnormalities were enrolled in this study according to the prediction equations established in1988. All subjects were assigned into 6 groups according to their age with30 males amd 30 females in each group. Pulmonary function parameters including VC, FVC, FEV1 , FEV1 /FVC, PEF, FEF25% , FEF50% , FEF75% , RV, FRC, TLC, RV /TLC, DLCO, and KCO were collected for analysis. New prediction equations for the above 14 parameters were established by parameters of anthropometry. The medical reference ranges of 14 parameters were calculated according to the newprediction equations. The normal FEV1 /FVC%pred was also calculated. Results New prediction equations for normal adult pulmonary function parameters in Shanghai were established. DLCO =5.206 +4. 314 ×gender ( “male”= 1, “female”=0) - 0. 144 ×age( y) +0. 098 × height( cm) +0. 082 ×weight( kg) , KCO =9. 346 - 0. 026 ×age( y) - 0. 031 ×height( cm) +0. 025 ×weight( kg) .The LLN( P5) of VC, FVC, FEV1 , FEV1 /FVC, the LLN( P2. 5 ) and the upper limit of normal value ( P97. 5) of FRC, TLC, RV, RV/TLC were calculated. The LLN( P5) of FEV1 /FVC = 101. 924 - 0. 144 × age ( y) - 0. 118 ×high( cm) . The lower normal limit of FEV1 /FVC% pred was 92% . Conclusions This is the first time to have the medical reference of FEV1 /FVC% pred in China, and new prediction equations for DLCO in Shanghai. The LLN of FEV1 /FVC or FEV1 /FVC% pred lt;92% can be used as diagnostic criteria for obstructive ventilation disorder. Instead of using FEV1% pred lt; 80% , FEV1 lt; LLN can be used as diagnostic criteria for mild ventilation disorder.
Objective To investigate the rate of pulmonary function test, medication treatment, and relevant factors among patients with chronic obstructive pulmonary disease (COPD) aged 40 years or older in community of Guangdong Province, and to provide evidences for targeted intervention of COPD. Methods A multistage stratified cluster sampling was conducted in the community residents, who participated in the COPD surveillance project of in Guangdong Province during 2019 to 2020. A total of 3384 adults completed questionnaire and pulmonary function test. The Rao-Scott χ2 test based on complex sampling design, and non-conditional Logistic regression were used to explore possible influencing factors of pulmonary function test and medication treatment in COPD patients. Results Out of the 3384 adults, 288 patients with COPD were confirmed, including 253 males (87.8%) and 35 females (12.2%), and 184 patients (60.4%) were over 60 years old or more. The pulmonary function test rate was 10.7% [95% confidence interval (CI) 6.8% - 14.6%], and medication treatment rate was 10.6% (95%CI 7.0% - 14.1%). The results showed that wheezing, awareness of COPD related knowledge and pulmonary function test were related to whether COPD patients had pulmonary function test (P<0.05). Wheezing and personal history of respiratory diseases were related to medication treatment rate (P<0.05). Conclusions The rates of pulmonary function test and medication treatment among COPD patients aged 40 years or older are low. Health education about COPD should be actively carried out, and the screening of individuals with a history of respiratory diseases and respiratory symptoms should be strengthened so as to reduce the burden of COPD diseases.
Objective To evaluate pulmonary function changes in patients with severe scol iosis undergoing anterior release, posterior segmental fixation and fusion, and convex thoracoplasty by resecting a short length of rib. Methods FromJanuary 2006 to July 2007, 16 patients with severe scol iosis were treated with anterior release, posterior segmental fixation and fusion, and convex thoracoplasty by resecting a short length of rib. There were 6 males and 10 females with an average age of 16.9 years (range, 10-24 years). There were 1 case of Lenke 1 curve, 9 cases of Lenke 2 curve, and 6 cases of Lenke 4 curve. The preoperative Cobb angle was (104.8 ± 10.9)° and the preoperative thoracic kyphotic angle was (30.0 ± 4.2)°. The preoperative height of “razor back” deformity was (5.9 ± 1.2) cm. Before operation, the actual value of forced vital capacity (FVC) was (2.04 ± 0.63) L and that of forced expiratory volume in 1 second (FEV1.0) was (1.72 ± 0.62) L. The percentage of actual values to expected ones in FVC was 70% ± 16%, and that in FEV1.0 was 67% ± 15%. All patients had pulmonary function tests before operation and 3, 6, 12, 24 months after operation. Results All wounds healed by first intention. The Cobb angle at 24-month follow-up was (53.4 ± 18.6)° and the correction rate was 49.0% ± 15.3%. The thoracic kyphotic angle at 24-month follow-up was (34.0 ± 2.4)° and the correction rate was 13.3% ± 2.2%. The height of “razor back” deformity at 24-month follow-up was (2.2 ± 0.8) cm. Compared with preoperative level, all these data showed significant differences (P lt; 0.05). At 3 and 6 months, the actual values of FVC and FEV1.0 decl ined, but no significant difference was found (P gt; 0.05). At 12 and 24 months, the actual values of FVC andFEV1.0 were close to the preoperative level (P gt; 0.05). The percentages of actual values to expected ones in FVC and FEV1.0 indicate continued improvement in pulmonary function from the postoperative 3 to 24 months follow-up. Compared with preoperative level, the percentages of actual values in FVC decl ined 19% 3 months postoperatively (P lt; 0.05) and 12% 6 months postoperatively (P lt; 0.05). The percentages of actual values to expected ones in FEV1.0 decl ined 16% 3 months postoperatively (P lt; 0.05), and 10% 6 months postoperatively (P lt; 0.05). The percentages of actual values to expected ones in FVC and FEV1.0 were close to the preoperative level 12 and 24 months after operation (P gt; 0.05). Conclusion In severe scol iosis patients who are treated with anterior release, posterior segmental fixation and fusion, and convex thoracoplasty by resecting a short length of rib, pulmonary function decreases obviously 3-6 months after operation. And it returns to the operative baseline 12-24 months after operation.
Objective To determine the efficacy of forced expiratory volume in six seconds( FEV6 ) as an alternative for forced vital capacity( FVC) in the diagnosis for mild-moderate chronic obstructive pulmonary disease( COPD) .Methods A total of 402 mild-moderate COPD and 217 non-COPD patients’ spirometric examinations were retrospectively analyzed. The correlation between FEV6 and FVC, FEV1 /FVC and FEV1 /FEV6 was evaluated by the Spearman test. Considering FEV1 /FVC lt;70% as being the ‘golden standard’ for airway obstruction, a ROC curve was used to determine the best cut-off point for the FEV1 /FEV6 ratio in the diagnosis for COPD. Results The Spearman correlation test revealed the FEV1 and FEV6 , FEV1 /FEV6 and FEV1 /FVC ratios were highly correlated ( r = 0. 992, 0. 980, respectively, P = 0. 000) . Using FEV1 /FEV6 lt; 70% as the diagnosis standard, 12. 69% of the 402 patients could not be diagnosed as COPD. The FEV1 /FVC ratio of these patients was very close to 70% . The best cut-off point for the FEV1 /FEV6 ratio in the diagnosis of mild-moderate COPD was 72% while the sensitivity and specificity were 94. 7% and 92. 2% , respectively. Conclusions There is a b correlation between FEV1 /FVC and FEV1 /FEV6 . The FEV6 can be a valid alternative for FVC in the diagnosis for mild-moderate COPD, although it may result in false negative. The best cut-off point for the FEV1 /FEV6 ratio is 72% .
0bjective To evaluate the efficacy of FEV6 and FEV1／FEV6 as surrogates for FVC and FEV1／FVC in the spirometric diagnosis of airway obstruction，and to determine the fixed cut-off point of FEV1／FEV6 which can be used as an alternative for FEV1／FVC lt; 70％.Methods Spirometry measurements were perform ed in 128 participants．FEV1，FEV6，FVC，FEV1％pred，FVC％pred，FEV1／FVC and FEV1／FEV6 were measured and analyzed.FEV1／FVClt;70％ was used as the“gold standard”。Severity of obstruction was based on FEV ％ pred．From ROC curve analysis，the FEV1／FEV6 ratio，which corresponded to optimal combination of sensitivity and specificity，was determined．Correlation between FEV1／FVC and FEV1／FEV6 was studied．Results Of 128 participants，there were 65(51％)with FEV1／FVC ≥70％ ．Of the 63 participants with FEV1／FVC lt;70％ ，there were 5 with FEV1／FEV6 between 70.09％ to 71％。There was no significant difference between the mean value of FVC and that of FEV ．Lifear correlation was revealed between FEV1／FVC and FEV1／FEV6 with the value close to 1(r=0.9979，Plt;0.0001)．From ROC curve analysis，the FEV1／FEV6lt;71.14％ was the best cut-off point coresponding to FEV1／FVC lt;70％ ．Conclusion These results suggest that FEV1／FEV6 is a valid alternative to FEV1／FVC for spirometric diagnosis of airw ay obstruction．There is a b corelation between FEV1／FEV6 and FEV1／FVC．
ObjectiveTo know about equipment of pulmonary function tests (PFTs) in community health service centers and the knowledge of pulmonary function in general physicians.MethodsThis questionnaire survey was carried out sponsored by Shanghai Basic Alliance for Respiratory Diseases Prevention and Treatment from June to December in 2016. Most community health service centers in 16 districts of Shanghai participated the survey. The questionnaire included education background, professional qualification, PFTs equipment, and knowledge about PFTs.ResultsThere were 963 general physicians in 131 community health service centers completed the questionnaire. There were 27 (20.6%) community health service centers equipped with simplified pulmonary function test device and 910 (94.5%) physicians knowing PFTs. Out of these 910 physicians, 458 physicians (50.3%) gave the correct answer on question about the items of PFTs. The accuracy of question about the diagnosis of chronic obstructive pulmonary disease (COPD) was 24.0% (218/910).ConclusionsThe rate of community health service centers with equipment on PFTs is low and the knowledge on pulmonary function in general physicians is insufficentt in Shanghai. Training on pulmonary function is essential to adapt the stratified treatment of COPD.