队列研究研究了解剖肺切除后呼吸障碍的演变和相关因素
Cecilia Pompili1,2, Javeria Tariq3, Sanjush Dalmia4
1Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research, St James's University Hospital, University of Leeds, Leeds, UK.
在非小细胞肺癌 (NSCLC) 手术后,呼吸障碍经常增加. 女性性别和较大的切除与呼吸障碍的增加有关,而细分切除可能会降低风险.
科学领域:
- 肺部病理学 肺部病理学
- 胸部外科手术 胸部外科手术
- 在瘤学瘤学.
背景情况:
- 呼吸不良是非小细胞肺癌 (NSCLC) 手术切除后的常见并发症.
- 术后呼吸障碍对生活质量和治疗结果的长期影响尚不清楚.
- 目前对肺切除后持久性呼吸不良风险因素的了解有限.
研究的目的:
- 为了评估患者报告的呼吸障碍在NSCLC的解剖肺切除后的长期演变.
- 确定与呼吸障碍临床上有意义的变化相关的患者特异性和手术因素.
主要方法:
- 一个单中心的纵向队列研究,对131名为NSCLC进行解剖肺切除的患者进行.
- 使用欧洲癌症研究和治疗组织 (EORTC) 生命质量问卷肺癌特异性呼吸不良度表 (LCS) 测量呼吸不良.
- 多变量回归分析确定了与手术后6-12个月呼吸障碍临床上有意义的术后变化相关的因素.
主要成果:
- 平均LCS得分从手术前的12.6增加到手术后6-12个月的17.9.
- 31%的患者经历了临床上有意义的呼吸障碍增加 (>10点).
- 女性性别是唯一与术后呼吸障碍增加相关的患者因素 (P=0.046).
- 与较大的切除相比,细分切除与呼吸障碍增加的风险较低 (34%对9%,P=0.014).
结论:
- 在肺切除后,很大一部分患者经历了临床上有意义的呼吸障碍.
- 术后呼吸障碍的进展很难仅仅使用基线因素来预测.
- 患者报告的结果和症状监测对于治疗肺部手术后呼吸障碍至关重要.
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