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. 胸外科圍手術期氣道管理專家共識(2012 年版).中國胸心血管外科臨床雜志, 2013, 20(3):251-255.
5.	楊為貴, 楊春, 聶文雙, 等. 肺功能不全食管癌患者的圍手術期處理. 中國胸心血管外科臨床雜志, 2011, 18(3):273-275.
6.	全志偉. 肺功能測定對腹部手術風險及術后并發癥的評估作用. 中國實用外科雜志, 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, 張志庸, 阿伊都·阿布都熱伊木. 開胸術后早期肺功能的變化規律及影響因素分析. 中華外科雜志, 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.	矯文捷, 王天佑, 龔民, 等. 非小細胞肺癌并COPD患者術后肺部并發癥分析. 中華臨床醫藥雜志, 2004, 5(2):15-17.
11.	俞婷婷, 謝德榮, 杜黎明, 等. 普米克令舒聯合可必特霧化吸入改善肺癌合并重度COPD患者術前肺功能及擴大手術適應癥研究. 臨床肺科雜志, 2013, 18(5):793-795.
12.	唐建新, 張貽秋, 向志, 等. 長期吸入糖皮質激素聯合異丙托溴銨治療COPD療效觀察. 臨床肺科雜志, 2008, 13(1):86.
13.	楊魯民, 矯文捷, 陳巖, 等. 中重度慢性阻塞性肺疾病合并肺癌圍手術期肺功能的保護. 中國腫瘤外科雜志, 2012, 4(2):67-71.
14.	中華醫學會兒科學分會呼吸學組《中華兒科雜志》編輯委員會. 兒童支氣管哮喘診斷與防治指南. 中華兒科雜志, 2008, 46(10):745-753.
15.	柳濤, 蔡柏薔. 慢性阻塞性肺疾病診斷、處理和預防全球策略(2011 年修訂版)介紹. 中國呼吸與危重監護雜志, 2012, 11(1):1-12.
16.	王天佑. 胸外科圍手術期肺保護的專家共識. 中華外科雜志, 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.	張國清, 朱光發. 大劑量沐舒坦防治呼吸窘迫綜合征的研究進展. 國外醫學:呼吸系統分冊, 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. 加強胸外科圍手術期氣道管理, 降低肺癌合并慢性阻塞性肺病患者并發癥. 中國胸心血管外科臨床雜志, 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. 胸外科圍手術期氣道管理專家共識(2012 年版).中國胸心血管外科臨床雜志, 2013, 20(3):251-255.
5. 楊為貴, 楊春, 聶文雙, 等. 肺功能不全食管癌患者的圍手術期處理. 中國胸心血管外科臨床雜志, 2011, 18(3):273-275.
6. 全志偉. 肺功能測定對腹部手術風險及術后并發癥的評估作用. 中國實用外科雜志, 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, 張志庸, 阿伊都·阿布都熱伊木. 開胸術后早期肺功能的變化規律及影響因素分析. 中華外科雜志, 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. 矯文捷, 王天佑, 龔民, 等. 非小細胞肺癌并COPD患者術后肺部并發癥分析. 中華臨床醫藥雜志, 2004, 5(2):15-17.
11. 俞婷婷, 謝德榮, 杜黎明, 等. 普米克令舒聯合可必特霧化吸入改善肺癌合并重度COPD患者術前肺功能及擴大手術適應癥研究. 臨床肺科雜志, 2013, 18(5):793-795.
12. 唐建新, 張貽秋, 向志, 等. 長期吸入糖皮質激素聯合異丙托溴銨治療COPD療效觀察. 臨床肺科雜志, 2008, 13(1):86.
13. 楊魯民, 矯文捷, 陳巖, 等. 中重度慢性阻塞性肺疾病合并肺癌圍手術期肺功能的保護. 中國腫瘤外科雜志, 2012, 4(2):67-71.
14. 中華醫學會兒科學分會呼吸學組《中華兒科雜志》編輯委員會. 兒童支氣管哮喘診斷與防治指南. 中華兒科雜志, 2008, 46(10):745-753.
15. 柳濤, 蔡柏薔. 慢性阻塞性肺疾病診斷、處理和預防全球策略(2011 年修訂版)介紹. 中國呼吸與危重監護雜志, 2012, 11(1):1-12.
16. 王天佑. 胸外科圍手術期肺保護的專家共識. 中華外科雜志, 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. 張國清, 朱光發. 大劑量沐舒坦防治呼吸窘迫綜合征的研究進展. 國外醫學:呼吸系統分冊, 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. 加強胸外科圍手術期氣道管理, 降低肺癌合并慢性阻塞性肺病患者并發癥. 中國胸心血管外科臨床雜志, 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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