ORIGINAL ARTICLE

FLOW-ORIENTED INCENTIVE SPIROMETER VERSUS VOLUME-ORIENTED
SPIROMETER TRAINING ON PULMONARY VENTILATION AFTER UPPER
ABDOMINAL SURGERY

By
Aly Rafea,1 Zeinab Mahmoud,2 Azza Nassef3
1Chest, 2Internal medicine and 3Clinical Pathology Departments, Al-Mataria Teaching Hospital, Egypt

Correspondence to: Aly Rafea, Email: ali.rafeah@yahoo.com

Background: The liver weighs about 3 pounds and is the largest solid organ in the body. It performs many important functions. Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrous scar tissue as well as regenerative nodules, leading to progressive loss of liver functions..
Aim of study: Study the blood coagulopathy and pulmonary embolism in patients with chronic liver cirrhosis.

Materials and Methods: Thirty patients who had proved chronic liver cirrhosis. Patients were selected from General Medicine Department El Matarya Teaching and El-Nile (Health Insurance) Hospitals. Patients were divided into:-Group A: Fifteen patients with complicated decompensated chronic liver cirrhosis such as ascites, deep vein thrombosis and hepatopulmonary syndrome. Group B: Fifteen patients with compensated liver cirrhosis (no ascites). Ten normal healthy subjects was participated in the present study as a controls (group C). Age of patients ranged from 40 to 65 years. Laboratory tests including: CBC, ESR, liver functions including (ALT, AST, S. Albumin), renal functions (s.urea and s.createnine); Coagulation profile (PT, INR and aPTT) was done by coagulometer..Serum D'Dimer estimation; Abdominal ultrasound and echo-doppler study for veins of lower limbs when indicated, CXR. ventilatory function(FVC,FEV1,FEV1/FVC%,FEF25-75%).
Pulmonary perfusion scan was performed with technetium 99 m (99 m Tc) - labeled macroaggregated albumin

Results: The current study revealed a highly significant restrictive ventilatory function, increased PT, aPTT, INR, serum D'Dimer level. Deep venous thrombosis/pulmonary embolism is not uncommon in liver cirrhosis

Conclusion: Although cirrhosis of the liver can cause many complications e.g. deficient coagulation and anticoagulation
factors, but deep venous thrombosis and pulmonary embolism is not uncommon in liver cirrhosis

Keywords: Liver cirrhosis, blood coagulopathy, pulmonary embolism.

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