Clinical study on freezing phrenic nerves for the patients of pulmonary lobectomy / 肿瘤研究与临床

ABSTRACT

Objective To investigate the results and effects of freezing phrenic nerves for the patients of pulmonary lobectomy.To optimize the best freezing time by studying the effects of different time at-65 ℃.Methods 50 patients of pulmonary lobectomy were randomly entered into 5 groups,including control group,30 seconds group,60 seconds group,90 seconds group,120 seconds group.After operation,the patients' cardiotach,blood pressure,SaO2,breath rate,time period of pulling out drainage tube and VAS about referred pain of scapular region were noted.After pulling out the intrathoracic drain tube,the routine chest normal X ray film and chest ultrasonic inspection were processed and the post-operation remnant cavity were observed.The chest normal fluoroscopy was inspected in 90 days after operation in order to observe the motion information of trouble side diaphragmatic muscle.Results The chest fluid [first day (329±178) ml,(345±150)ml,(268±51) ml,(227±36) ml,second day (251±131) ml,(269±112) ml,(208±61) ml,(158±110) ml,time of pulling out intrathoracic drain tube (5.8±1.75) days,(4.6±1.77) days,(3.9±0.74) days,(3.6±1.07) days] and VAS [(3.6±2.9) scores,(2.2±2.4) scores,(1.0±1.3) scores,(0.7±1.2) scores] about referred pain of scapular region of freezing groups were obviously lower than those in the control group [(375±136) ml,(309±132) ml,(5.7±2.36) days,(4.0±3.3) scores].90 s and 120 s freezing groups were lower than that of 30 s and 60 s groups,andthe 90 s freezing group did not significantly different from the 120 s group.The heart rate,blood pressure,saturation of blood oxygen and breathing rate of each group also had no difference.The remnant cavity sizes were larger in the control group (＞200 ml),they also had more fluidity (＞200 ml),and one case had been taken punctuation.The remnant cavity sizes of freezing groups were small and didn' t need special treatment.The diaphragmatic muscle' s movement of each group were fine after 3 months of operation.Conclusion The freezing phrenic nerves can effectively reduce the chest fluid,the post-operation remnant cavity and the time of pulling out intrathoracic drain tube.The freezing phrenic nerves can reduce the pain of referred pain of scapular region.The best freezing time should be 90 s.The freezing phrenic nerves do not influence the respiration function,and should be advantages of for the clinic researches and applications.