Sarna Linda, Evangelista Lorraine, Tashkin Donald, Padilla Geraldine, Holmes Carmack, Brecht Mary Lynn, Grannis Fred
School of Nursing, University of California-Los Angeles, 700 Tiverton Avenue, Box 9569182, Factor 4-262, Los Angeles, CA 90095-6918, USA.
Chest. 2004 Feb;125(2):439-45. doi: 10.1378/chest.125.2.439.
To describe respiratory symptoms and pulmonary function among long-term survivors of non-small cell lung cancer (NSCLC), and their relationship to quality of life (QOL).
Cross-sectional survey of disease-free, 5-year minimum survivors of NSCLC (n = 142; 54% women; average age, 71 years); the majority (74%) had received a lobectomy. Analysis included frequency of self-reported respiratory symptoms (cough, phlegm, wheezing, breathlessness) as measured by the American Thoracic Society questionnaire, pulmonary function findings from hand-held spirometry, and QOL (Short Form-36).
Two thirds of survivors reported at least one respiratory symptom (mean, 1.3; SD, 1.2): 25% cough, 28% phlegm, 31% wheezing, and 39% dyspnea. Twenty-one percent reported that they spent most of the day in bed in the past 12 months because of respiratory symptoms. Average FEV(1) percentage predicted was 68% (SD, 23); 21% had < 50% predicted FEV(1). Based on spirometry results, 36% had a moderate/severe obstructive and/or restrictive ventilatory disorder. Survivors exposed to second-hand smoke (28%) were more than three times as likely to report respiratory symptoms. Respiratory symptom burden contributed to diminished QOL in several domains.
The majority of these survivors experienced respiratory symptoms, and more than one third reported dyspnea, including one of five patients with seriously diminished pulmonary function. Symptom burden, rather than ventilatory impairment, contributed to diminished QOL. Further study is needed to determine the patterns and effective management of posttreatment respiratory symptoms on survivors of lung cancer.
描述非小细胞肺癌（NSCLC）长期幸存者的呼吸道症状和肺功能，以及它们与生活质量（QOL）的关系。
对NSCLC无病生存至少5年的患者进行横断面调查（n = 142；54%为女性；平均年龄71岁）；大多数（74%）接受了肺叶切除术。分析内容包括通过美国胸科学会问卷测量的自我报告呼吸道症状（咳嗽、咳痰、喘息、呼吸困难）的频率、手持式肺活量测定法的肺功能结果以及生活质量（简明健康状况调查简表36）。
三分之二的幸存者报告至少有一种呼吸道症状（平均1.3种；标准差1.2）：25%咳嗽，28%咳痰，31%喘息，39%呼吸困难。21%的人报告在过去12个月中因呼吸道症状大部分时间卧床。预计第一秒用力呼气容积（FEV₁）平均百分比为68%（标准差23）；21%的人预计FEV₁<50%。根据肺活量测定结果，36%的人有中度/重度阻塞性和/或限制性通气障碍。接触二手烟的幸存者（28%）报告呼吸道症状的可能性是其他人的三倍多。呼吸道症状负担导致几个领域的生活质量下降。
这些幸存者中的大多数经历了呼吸道症状，超过三分之一的人报告有呼吸困难，包括五分之一肺功能严重受损的患者。症状负担而非通气功能损害导致生活质量下降。需要进一步研究以确定肺癌幸存者治疗后呼吸道症状的模式和有效管理方法。
