Objective postoperative pulmonary complications and short-term prognosis

to explore the risk factors leading to diaphragm dysfunction.Methods excursion was measured sequentially for each patient before and 24 h

48 h

and 72 h after operation by bedside ultrasound.According to the postoperative diaphragmatic excursion

the patients were divided into diaphragm dysfunction group（DD group

n=54）and Normal diaphragmatic function group（ND group

n=36）.The differences of the incidence of postoperative pulmonary complications and short-term prognosis between the two groups were compared.Logistic regression was used to analysis the risk factors leading to diaphragm dysfunction.Results postoperative residual cavity

pleural effusion

and lung infection)in the DD group were higher than those in the ND group

and the differences were statistically significant（all P<0.05）.The short-term prognosis of the DD group（the time to complete lung recruitment and post-operative catheterization） were worse than those of the ND group

the difference were statistically significant（both P<0.05）.In both groups

diaphragmatic excursion first decreased and then increased on the operative side

while it remained unchanged on the opposite side at 48 h after operation and increased compensatively from 72 h after operation.Logistic regression analysis showed that smoking history and lobectomy were risk factors for postoperative diaphragmatic dysfunction（OR=4.347

3.153

both P<0.05）.Conclusion incidence of pulmonary complications

which is not conducive to short-term prognosis. Bedside ultrasound can be used to measure the diaphragmatic excursion during peri-operative period

and early detection of diaphragm dysfunction

which can provide help for clinical strategies.