Objective To study the influence of continuous blood purification(CBP)on the intra-abdomi-nal pressure (IAP ) and the gastrointestinal dysfunction of intra -abdominal hypertension (IAH ).Methods 80 patients with IAH were selected and divided into observation group and control group(n=40)according to random number table method.The observation group was given 3d CBP therapy.The control group was given conventional treatment.The mean arterial pressure (MAP ),IAP and abdominal perfusion pressure (APP ) were detected.The number of gastrointestinal symptoms was observed,sequential organ failure score(SOFA score)was used to assess the organ function of the two groups before and after treatment.Results The MAP,IAP,APP,SOFA score of the two groups before treatment had no statistically significant differences(P>0.05).The MAP of the two groups after treat-ment[(88.46 ±8.93)mmHg vs.(87.76 ±8.04)mmHg]had no statistically significant difference(P>0.05).The IAP[(9.02 ±1.06)mmHg]and SOFA score[(1.32 ±0.45)]of the observation group after treatment were signifi-cantly lower,the APP [(85.34 ±7.59)mmHg]was obviously higher than before treatment and the control group [(19.54 ±4.23)mmHg,(5.24 ±2.05)points,(70.76 ±6.43)mmHg],the differences were statistically significant (t=3.575,2.855,3.274,3.563,3.114,3.782,all P<0.05).Before treatment,the number of the gastrointestinal symptoms of the two groups[(44.56 ±8.53)times vs.(45.32 ±8.21)times]had no statistically significant difference (P>0.05).The number of gastrointestinal symptoms of the observation group after treatment [(6.54 ±2.24)times] was obviously lower than before treatment and the control group [(15.45 ±4.43)times],the difference was statisti-cally significant(t =3.022,P<0.05 ).The 30 d and 60 d survival rates of the observation group were 87.5%(35/40)and 65%(26/40),which of the control group were 80.0%(32/40)and 55%(22/40),although which of the observation group were higher than the control group,but there were no statistically significant differences(P>0.05 ).Conclusion CBP could significantly reduce the IPA of the patients with IAH,raise the APP,improve gastro-intestinal perfusion,reduce gastrointestinal symptoms,has positive significance to improve the gastrointestinal dysfunction.

Objective:To compare the effects of thoracoscopic anatomical segmentectomy and thoracoscopic lobectomy on patients' respiratory function.Methods:Retrospective analysis of 326 patients who underwent thoracoscopic surgery from July 2016 to July 2019(209 patients underwent anatomical segmentectomy, 117 patients underwent lobectomy). According to variables including gender, age, tumor location, smoking history and BMI, two propensity score-matched cohorts including 89 patients respectively were constructed. The patients’ baseline data and respiratory function date of the patients pre-operation and post-operation were analyzed. The measurement data that obey the normal distribution were described by mean±standard deviation, and the t-test was used for comparison between groups; the measurement data of non-normal distribution was described by the median value( P25, P75), and the Wilcoxon rank sum test was used for the comparison between groups; The data was described by frequency, and the chi-square test or Fisher's exact probability method was used for comparison between groups. Results:At the first-month follow-up after surgery, there was no significant difference in the variation of FVC[(0.48±0.40)L vs.(0.34±0.37)L, P=0.215)and FEV1[(0.52±0.46)L vs.(0.43±0.77)L, P=0.364), and in the change rate of FVC(%)[15.23(8.74, 21.25) vs. 14.58(7.75, 19.40), P=0.122], FEV1(%)[17.25(9.56, 22.78) vs. 16.42(9.15, 20.28), P=0.154]and DLCO(%)[18.54(10.88, 25.68)vs. 17.45(9.58, 23.75) P=0.245]. Between the segmentectomy group and lobectomy group, there was a significant difference in the alteration of FVC[(0.50±0.47)L vs. (0.29±0.31)L, P=0.031] and FEV1[(0.44±0.34)L vs.(0.24±0.23)L, P<0.001], the change rate of FVC(%)[14.27(7.87, 22.32) vs. 9.95(5.56, 17.24), P=0.008]、FEV1(%)[15.23(8.36, 22.17)vs. 10.05(5.15, 18.54), P<0.001]and DLCO(%)[13.74(6.24, 19.78) vs. 4.45(-2.32, 13.75), P=0.023]in the 6th month after surgery. The lobectomy group had a higher variation of FEV1[(0.34±0.49)L vs.(0.18±0.26)L, P=0.006] and change rate of FVC(%)[9.28(2.15, 18.94) vs. 5.24(0.52, 11.45), P=0.0032] and FEV1(%)[10.45(3.15, 21.32) vs. 6.50(1.55, 14.24), P<0.001] in the first year after surgery. However, the variation of FVC[(0.29±0.36)L vs.(0.21±0.24)L, P=0.176) and the change rate of DLCO(%)[8.35(2.15, 16.45) vs. 6.23(2.12, 14.54), P=0.143] didn't show a significant difference between the two groups. Conclusion:Whether in the short or the middle postoperative period, segmentectomy can preserve postoperative respiratory function than lobectomy.