Treatment of acute cholangitis with hepatolithiasis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the treatment of recurrent acute cholangitis with hepatolithiasis.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of patients with recurrent acute cholangitis who were treated in Peking Union Medical College Hospitals emergency department from January 1998 to December 2008.</p><p><b>RESULTS</b>Totally 408 patients underwent surgery, of which 167 patients received emergency operations and 241 underwent selective operations after medication and interventional treatment. The incidence of complications was 6.4% among those who received emergency operations and 3.2% among selective operations. The 30-day mortality rate of selective operations was zero.</p><p><b>CONCLUSION</b>Along with the progress of percutaneous cholangiographic drainage and endoscopic retrograde cholangiopancreatography, selective operations have been increasingly applied for acute cholangitis with notably low complications and postoperative death.</p>

The analysis of changes and influencing factors of early postthoracotomy pulmonary function / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the changes and influencing factors of early postoperative pulmonary function of thoracotomy.</p><p><b>METHODS</b>Pre- and early postoperative pulmonary function was studied in 64 consecutive cases with optimal thoracotomy. Pain assessment was done before pulmonary function test, and the chief complaints of patients were recorded after the procedure. The changing curves of pulmonary function were done and the differences associated with groups, surgical styles, pain assessment, epidural analgesia, chief complaint and preoperative conditions were analyzed.</p><p><b>RESULTS</b>Pulmonary function was severely lowered to about 40% of the base line on the first day, and it was rehabilitated to about 60% of the base line on the eighth day. There was a greater gradient on the recovery curve on the 3rd and 4th days. Epidural analgesia was able to improve pain relaxation and pulmonary function in some degree. Single-factor analysis showed that postoperative pain, postoperative day and surgical style were the significant influencing factors for early postoperative pulmonary function. By multiple-factor analysis, preoperative pulmonary function, age and postoperative pain were the main factors, while surgical style had only weak effect on it.</p><p><b>CONCLUSIONS</b>Early postoperative pulmonary function is severely impaired by thoracotomy. It rehabilitate gradually with time. Improvement of preoperative pulmonary function, reducing surgical procedure injuries, especially injury to respiratory muscle system, and enough postoperative pain relief are the most important means that would reduce pulmonary function impairment and consequently reduce postoperative pulmonary complications.</p>