Comparison of changes in early pulmonary function and hemodynamic between unilateral and bilateral lung volume reduction for chronic obstructive pulmonary disease / 中华外科杂志

<p><b>OBJECTIVE</b>To compare changes in early pulmonary function and hemodynamics between unilateral and bilateral lung volume reduction (LVRS) for severe chronic obstructive pulmonary disease (COPD).</p><p><b>METHODS</b>Eighty-six patients with severe COPD underwent LVRS, 61 underwent unilateral LVRS and 25 underwent lateral LVRS. The results of lung function (FEV(1), RV, TLC), arterial blood gas analysis (PaO(2), PaCO(2)) and color Doppler echocardiography (CO, CI, EF, PAP) were evaluated preoperatively and 3, 6 months postoperatively.</p><p><b>RESULTS</b>Six patients died. FEV(1), RV and TLC were improved significantly after (P < 0.05). PaO(2) increased (P < 0.05) and PaCO(2) decreased postoperatively (P < 0.05). According to the Doppler echocardiography there were no statistic difference in cardia functions (CO, CI, EF, PAP) between unilateral and bilateral LVRS preoperatively and 3, 6 months postoperatively.</p><p><b>CONCLUSIONS</b>Unilateral and bilateral LVRS is safe and effective in the treatment of patients with severe COPD, the pulmonary function significantly improved postoperatively, but the results of bilateral LVRS is better than unilateral. Both unilateral and bilateral LVRS showed no significant deterioration in hemodynamics, there were no significant difference between preoperatively and postoperatively.</p>

Diagnosis and treatment for pulmonary thromboembolism in postthoracotomy patients / 中华外科杂志

<p><b>OBJECTIVE</b>To report the experience in the diagnosis and treatment of pulmonary thromboembolism (PTE) in postthoracotomy patients and to analyze current problems in this field.</p><p><b>METHODS</b>From January 2001 to June 2002 we diagnosed and treated 5 patient who had pulmonary thromboembolism, 72-168 hours after thoracotomy (male 4, female 1, mean age 63 years). Symptoms include breathholding, chest pain, palpitation, coma and so on. Physical signs include tachypnea, hypotension and tachycardia. We utilized spiral CT pulmonary artery angiography (SCTPA) and Doppler echocardiography to judge PTE. Pulmonary artery interventional therapy was used in 3 cases and total body thrombolysis in 1.</p><p><b>RESULTS</b>4 patients recovered with no complication and recurrence; 1 patient died from congestive heart failure and respiratory failure.</p><p><b>CONCLUSION</b>Deep venous thrombosis (DVT) and PTE are related to the surgical intervention, chest tumor and thoracotomy is high risk factors. Screenage examination is primary to used. Pulmonary artery interventional therapy is safe to the postthoracotomy patients. Preventive measures is very important in the high-risk group.</p>