1972 年 32 巻 12 号 p. 673-686
The chemotherapy has been developed today, but pulmonary complication is still one of serious post operative complications. It is well known that obstructive type of ventilatory defect, for which inhalation therapy is effective, is one important facter for occurrence of the post operative pulmonary complication. Therefore the author studied the influence of inhalation of bronchodilator with intermittent positive pressure breathing (I. P. P. B) on blood gas, pulmonary function in the preoperative patients with or without chronic broncho-pulmonary disease. Furthermore the author investigated the relationship among the results of preoperative pulmonary function tests, their change by inhalation therapy and postoperative pulmonary complications in the patients who underwent operation with endotracheal anesthesia. The results are as follows.
1) Minute uolume (VE) CO2 output (Vco2) and O2 uptake (Vo2) of Asthmatic patients were higher than those of healthy subjects. But partial pressure of Ca2 in arterial blood (Paco2) was same as that of healthy subjects.
2) VE, Vco2 and Vo2 of the general inpatients who expectorated sputum with I.P.P.B. decreased with treatment than those without expectoration, but peak flow rate, forced expiratory volume in one second (FEV1), Vital capacity (V.C) of the former increased more than the latter. But effects of IPPB therapy in the patients with chronic bronchopulmonary disease were not clear except improvement of expiratory capacity such as peak flow rate, percentage forced expired in one second (% FEV1) and functional residual capacity (FRC) .
3) All cases of thoracotomy and the many cases of major abdominal surgery suffered from post operative respiratory complications. However, they were chiefly minor complications, such as increase of sputum. Peak flow rate, percentage of actual to predicted vital capacity (% VC) of patients with complication were higher than those without. But it was found no rvlationship between the change of pulmonary function by aerosol inhalation with IPPB and postoperative respiratory complication.