CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 6, November/December 2022 AFRICA 293 all had significantly increased seven days after the operation compared with those before operation (p < 0.05). In the low-level group, postoperative FEV1, FEV1%pred and FEV1/FVC were significantly higher, and 6MWT distance was significantly longer than those in the other two groups, while the postoperative exhaust time was significantly shorter than that in the other two groups. In addition, the low-level group had significantly shorter length of postoperative hospital stay than the high-level group (p < 0.05). There was no significant difference in the stitch removal time in the three groups (p > 0.05) (Table 5). Postoperative complications occurred in a small number of patients, including pulmonary oedema, pulmonary infection, hypertension, arrhythmia and pulmonary embolism. The incidence rate of postoperative complications was not significantly different between the low-level (3.51%), middle-level (8.77%) and high-level groups (10.53%) (p > 0.05) (Table 6). Discussion Lung cancer, a common malignancy, has a high incidence rate. Its mortality rate is the highest among male patients worldwide and among female patients in developed countries.11 Lung cancer is caused by many factors, mainly including occupational toxic exposure, tobacco, genetic factors, chronic respiratory diseases and environmental pollution.12 Histologically, lung cancer can be classified into SCLC and NSCLC, which are mainly treated with chemoradiotherapy and lobectomy, respectively.13 With the development of minimally invasive surgical techniques, these have been widely applied in the surgical treatment of a variety of diseases. Compared with traditional open lobectomy, thoracoscopic lobectomy can completely remove the lesions and possesses such advantages as milder postoperative pain, less trauma, faster postoperative Table 2. Respiratory function at different time points Variables Low-level group (n = 57) Middle-level group (n = 57) High-level group (n = 57) PaO2 (100 mmHg) T1 402.48 ± 90.35 405.64 ± 88.26 398.73 ± 85.42 T2 202.18 ± 80.42 198.64 ± 79.85 195.73 ± 76.65 T3 358.65 ± 98.31 361.18 ± 100.49 365.72 ± 102.44 PaCO2 (100 mmHg) T1 40.64 ± 3.12 41.26 ± 2.85 40.35 ± 2.73 T2 39.18 ± 2.92 40.87 ± 2.94 40.78 ± 3.05 T3 39.34 ± 2.61 41.65 ± 3.22 38.96 ± 2.49 LC (l/cm H2O) T1 39.12 ± 7.05 38.47 ± 6.85 37.96 ± 6.24 T2 26.08 ± 5.12 25.83 ± 4.87 26.54 ± 5.23 T3 35.42 ± 5.73 36.18 ± 6.05 36.43 ± 5.85 PAP (100 mmHg) T1 15.96 ± 2.42 16.03 ± 2.58 15.37 ± 2.18 T2 23.15 ± 3.41 22.85 ± 3.07 22.67 ± 2.83 T3 17.85 ± 3.28 17.69 ± 3.31 17.26 ± 2.99 PaO2: arterial partial pressure of oxygen; PaCO2: arterial partial pressure of carbon dioxide; LC: lung compliance; PAP: peak airway pressure; T1: time of stable breathing and haemodynamics during two-lung ventilation after doublelumen tube tracheal intubation; T2: time of stable breathing and haemodynamics after two-lung ventilation is replaced with one-lung ventilation; T3: time of stable breathing and haemodynamics after one-lung ventilation is replaced with two-lung ventilation. Table 3. Haemodynamics at different time points Variables Low-level group (n = 57) Middle-level group (n = 57) High-level group (n = 57) HR (beats/min) T2 70.68 ± 6.52 71.15 ± 6.28 72.31 ± 7.02 T3 72.41 ± 6.94 75.65 ± 7.92 79.28 ± 8.43* MAP (mmHg) T2 94.72 ± 9.21 95.31 ± 8.94 97.36 ± 9.64 T3 98.31 ± 8.42 97.64 ± 9.28 87.42 ± 8.85* CVP (mmHg) T2 7.85 ± 1.47 7.43 ± 1.29 7.12 ± 1.31 T3 6.65 ± 1.34 5.12 ± 1.25* 5.64 ± 1.06* SV (ml) T2 69.92 ± 9.74 70.22 ± 10.18 71.37 ± 10.85 T3 82.96 ± 9.46* 78.87 ± 8.25* 76.31 ± 8.75 HR: heart rate; MAP: mean arterial pressure; CVP: central venous pressure; SV: stroke volume; T2: time of stable breathing and haemodynamics after two-lung ventilation is replaced with one-lung ventilation; T3: time of stable breathing and haemodynamics after one-lung ventilation is replaced with two-lung ventilation. *p < 0.05 vs T2. Table 4. Use of vasoactive drugs in the three groups Vasoactive drugs Low-level group (n = 57) Middle-level group (n = 57) High-level group (n = 57) Anisodamine (mg) 0.32 ± 0.17 0.35 ± 0.18 0.29 ± 0.14 Dopamine (mg) 26.12 ± 12.31 33.98 ± 12.47* 48.72 ± 13.42*# Norepinephrine (μg) 27.85 ± 14.37 42.06 ± 20.18* 52.05 ± 23.16*# Esmolol (mg) 7.85 ± 3.74 9.62 ± 4.06* 12.13 ± 5.28*# Isosorbide dinitrate (mg) 6.59 ± 2.31 7.22 ± 2.42 8.13 ± 3.12* *p < 0.05 vs low-level group; #p < 0.05 vs middle-level group. Table 5. Short-term prognosis indices Variables Low-level group (n = 57) Middle-level group (n = 57) High-level group (n = 57) FEV1 (l) Before operation 1.48 ± 0.35 1.46 ± 0.32 1.50 ± 0.31 7 days after operation 2.35 ± 0.82# 1.96 ± 0.73*# 1.75 ± 0.68*#§ FEV1%pred (%) Before operation 34.65 ± 6.83 33.96 ± 5.41 33.69 ± 5.52 7 days after operation 40.85 ± 6.18# 38.51 ± 5.83*# 36.15 ± 5.62*#§ FEV1/FVC (%) Before operation 52.18 ± 8.15 52.24 ± 8.25 52.79 ± 8.31 7 days after operation 69.47 ± 8.75# 62.42 ± 8.22*# 58.41 ± 7.88*#§ 6MWT distance (m) Before operation 263.74 ± 30.18 262.65 ± 31.40 260.73 ± 30.25 7 days after operation 306.72 ± 41.25# 280.17 ± 38.16*# 265.14 ± 40.38*#§ Postoperative exhaust time (hours) 83.16 ± 20.15 91.37 ± 22.74* Stitch removal time (days) 12.31 ± 3.14 12.65 ± 2.87 Length of postoperative hospital stay (days) 15.26 ± 4.84 16.58 ± 5.12 FEV1: forced expiratory volume in one second; FEV1%pred: percentage of FEV1 in the predicted value; FEV1/FVC: forced expiratory volume in one second/ forced vital capacity; 6MWT: six-minute walk time. *p < 0.05 vs low-level group; #p < 0.05 vs middle-level group; §p < 0.05 vs before operation. Table 6. Incidence of complications in the three groups Complications Low-level group (n = 57) Middle-level group (n = 57) High-level group (n = 57) Pulmonary oedema 0 0 1 Pulmonary infection 0 1 0 Hypertension 1 2 3 Arrhythmia 1 1 1 Pulmonary embolism 0 1 1 Total, n (%) 2 (3.51) 5 (8.77) 6 (10.53)
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