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Objective To investigate the effect of preoperative and postoperative inspiratory muscle training(IMT) on cardiopulmonary function and quality of life for patients undergoing esophagectomy.Methods Sixty patients who had received esophagectomy for esophageal cancer were randomly divided into an observation group (n =30) and a control group (n =30).All of the subjects were given conventional treatment (including preoperative health education,abdominal respiration training,pursed lip respiration training and expectoration training).On this basis,the patients in the treatment group were advised to do deep respiratory training using a breathing training device,four times a day,lasting 20 minutes each time,for 10 days (including five days before and five days after the operation).Respiratory muscle strength,blood gases,six minute walk test (6MWT) distances and Borg dyspnea scores were measured on admission,on the day prior to the operation and on the 1st,3rd and 5th day after the operation.And also on admission and on the 5th day after the operation their pulmonary function was tested,and their psychological status and quality of life were evaluated using the hospital anxiety and depression scale (HADS) and the Nottingham health profile (NHP) respectively.Results There was no significant difference in any index between the two groups on admission(P ＞ 0.05).Everyone's respiratory function and exercise capacity were sharply decreased,and Borg dyspnea score increased on the first postoperative day,and then gradually and significantly improved in both groups compared to that on admission(P ＜ 0.05).On the fifth postoperative day,the maximal inspiratory pressure of 67.41 ± 14.53 mmH2O,maximal ventilatory volume of 79.83 ± 5.37 L,6MWT of 427.19 ± 46.52 m,Borg score of 1.45 ± 0.48 points,postoperative anxiety score of 8.14 ±2.80 points,NHP total (128.91 ± 25.12 points),NHP pain score (24.66 ± 10.12 points),NHP sleeping score (25.18 ± 9.75 points),and NHP physical activity scores (22.81 ± 10.72 points) were significantly more improved in the observation group than those in the control group(P ＜ 0.05).Conclusion Preoperative and postoperative inspiratory muscle training can significantly reduce postoperative anxiety symptoms,improve postoperative cardiopulmonary function and the quality of life during perioperative period.Such therapy deserves further clinical research.
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Objective To investigate the effect of dexmedetomidine on cognitive dysfunction after offpump coronary artery bypass grafting in patients.Methods Fifty-eight ASA physical status Ⅱt or Ⅲ patients,aged 51-63 yr,weighing 52-83 kg,undergoing off-pump coronary artery bypass grafting,were randomly divided into 2 groups (n =29 each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with midazolam,etomidate,sufentanil and pipecuronium.The patients were thracheal intubated and mechanically ventilated.Anesthesia was maintained with propofol,sufentanil,isoflurane and pipecuronium.A loading dose of dexmedetomidine 1 μg/kg was infused over 15 min after tracheal intubation,followed by dexmedetomidine infusion at 0.5 μg· kg-1 · h-1 until the end of operation in group D,while the equal volume of normal saline was infused in group C.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 24 h before operation and 24,48 and 72 h after operation.The development of postoperative cognitive dysfunction was recorded within 72 h after operation.The consumption of sufentanil and extubation time after extubation was recorded.Results Compared with group C,MMSE scores at 24 and 48 h after operation were significantly increased and the incidence of postoperative cognitive dysfunction within 72 h after operation was decreased (P ＜ 0.05),and no significant change was found in the consumption of sufentanil and extubation time in group C (P ＞ 0.05).Conclusion Dexmedetomidine can decrease the development of postoperative cognitive dysfunction after off-pump coronary artery bypass grafting in patients.
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Objective:To investigate the protective effect of preconditioning with Puerarin on myocardial ischemia reperfusion in adult SD rats and its possible mechanism.Methods:Forty Male SD rats were divided randomly into five groups(n=8).The myocardial injury of rats ware produced by the ligation of left coronary artery for 30 min followed by 120 min reperfusion.LVSP,LVEDP,and ?dp/dtmax were recorded at ischemia 30 min,reperfusion 60,90 and 120 min.The myocardial infarct size and the level of NO and NOS were observed.Results:In group I/R,the systolic and diastolic function were significantly reduced;myocardial infarct size was increased;NO and NOS were significantly lowered compared with those in group SH(P