ABSTRACT
Objective:To investigate the effect of bel canto breathing training method on the respiratory rehabilitation of patients with chronic obstructive pulmonary disease in stable stage.Methods:Using a quasi-experimental research method, 40 patients with chronic obstructive pulmonary disease in stable stage from September to December 2018 in two wards (the first ward and the second ward) with the same level of diagnosis and treatment of respiratory physicians, nurses' nursing ability and the ward environment of the First Hospital of Lanzhou University were selected. The first ward was used as the experimental group, and the second ward was used as the control group, there were 20 cases in each group. The patients in the experimental group were given bel canto breathing training and conventional breathing training, while the patients in the control group were given conventional breathing training. A WeChat group was established, and training videos were distributed in the WeChat group after discharge to urge patients to perform training. After 3 months of intervention, the quality of life, anxiety, depression, and pulmonary function were evaluated by St George′s Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Scale (HADS), proportion of forced expiratory volume in forced vital capacity in the first second(FEV1/FVC).Results:The SGRQ score, HADS score and FEV1/FVC value in the experimental group before intervention respectively were (41.35 ± 9.94), (16.55 ± 4.29) points and (47.13 ± 8.85)%, at discharge respectively were (28.95 ± 5.66), (11.20 ± 2.75) points and (59.51 ± 10.49)% and after three months of intervention respectively were (21.75 ± 6.31), (7.15 ± 3.51) points and (66.69 ± 7.87)%, while the SGRQ score, HADS score and FEV1/FVC value in the control group before the intervention respectively were (42.10 ± 10.50), (16.60 ± 4.73) points and (46.23 ± 10.14)%, at discharge respectively were (34.90 ± 10.16), (13.35 ± 2.37) points and (52.91 ± 7.86)%, and after three months of intervention (35.80 ± 7.27), (14.20 ± 5.05) points and (52.65 ± 8.60)%. With the increase of the intervention time of bel canto breathing training, the SGRQ score and HADS score decreased ( F=29.65, 17.44, both P<0.05), and the FEV1/FVC value increased ( F=27.38, P<0.05). Within-group comparisons the SGRQ score, HADS score, and FEV1/FVC value in the experimental group at discharge, three months after the intervention versus pre-intervention, and three months after the intervention versus discharge showed statistically significant differences ( t values were -7.73 - 7.38, all P<0.05). SGRQ score, HADS score, and FEV1/FVC value in the control group were only statistically significant at discharge versus pre-intervention ( t=-4.63, -2.79, 5.28, all P<0.05). The SGRQ, HADS score and FEV1/FVC value between the 2 groups were not statistically significant before the intervention, but statistically significant at discharge and three months after the intervention ( t values were -6.53 - 5.39, all P<0.05). Conclusions:Bel canto breathing training can improve the quality of life, reduce anxiety, depression and increase FEV1/FVC in patients with chronic obstructive pulmonary disease in stable stage.
ABSTRACT
Objective To evaluate the changes in the status of macrophages during the non-ventilated lung injury in the patients undergoing long-time one-lung ventilation (OLV).Methods Thirty patients of both sexes,aged 35-64 yr,weighing 50-80 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective pulmonary lobectomy for lung cancer,were divided into 2 groups (n=15 each) according to the time of OLV:short-time OLV group (＜30 min,group S) and long-time OLV group (＞2 h,group L).Anesthesia was routinely induced and maintained.Normal lung tissues around the cancer tissues from the lobe of the lung excised were obtained for microscopic examination of pathologic changes which were scored.The activated macrophages (CD68 positive),polarized M1 macrophages (CD86 positive) and polarized M2 macrophages (CD206 positive) in lung tissues were detected using immunofluorescence.The ratio of CD86 positive cells to CD206 positive cells was calculated.Results Compared with group S,lung injury scores on the non-ventilated side were significantly increased,the number of CD68,CD86 and CD206 positive cells in lung tissues was increased,and the ratio of CD86 positive cells to CD206 positive cells was increased in group L (P＜0.05).Conclusion Long-time OLV (＞2 h) can result in increased number of activated macrophages,especially the polarized M1 macrophages,which may be one of the mechanisms underlying lung injury on the non-ventilated side.
ABSTRACT
Objective To investigate the effect of sevoflurane preconditioning on lung compliance and oxygenation index during one lung ventilation( OLV) . Methods In this study, sixty patients, ASAⅠorⅡ, scheduled for pul-monary surgeries were enrolled, and randomly divided into two groups:sevoflurane preconditioning group(n=30) and total intravenous group( n=30 ) . For preconditioning, patients in sevoflurane preconditioning group were ad-ministrated with one minimal alveolar concentration(1MAC) sevoflurane for 30 min after general anesthesia induc-tion and then followed with total intravenous anesthesia. While in total intravenous group, only intravenous anes-thetic agents were administrated for maintenane of anesthesia after induction. The indexes of hemodynamics, pulse oximeter( SpO2 ) , plateau pressure( Pplat) and lung compliance( Cdyn) were recorded at the following time points:before anesthesia( T0 ) , after anesthesia induction at laternal position TLV 30 min( T1 ) ,30 min after OLV( T2 ) , 60 min after OLV( T3 ) and recovering TLV 20 min( T4 ) . Arterial blood samples were taken to measure partial pressure of carbon dioxide( PaCO2 ) , partial pressure of oxygen( PaO2 ) , pH, oxygenation index( PaO2/FiO2 ) at the follow-ing time points: T1 , T2 , T3 , T4 . Results Compared with T1 , the oxygenation index and lung compliance de-creased significantly at T2 ,T3 ( P<0. 05 ); compared with total intravenous group, the lung compliance was obvi-ously higher than that in sevoflurane preconditioning group at T2,T3(P<0. 05). There were no significantly differ-ences in the oxygenation index between total intravenous group and sevoflurane preconditioning group at all time points. Conclusion Compared with total intravenous anesthesia with propofol , sevoflurane preconditioning can im-prove lung compliance, but does not make contribute to improve oxygenation index.