Brunelli Alessandro, Socci Laura, Refai Majed, Salati Michele, Xiumé Francesco, Sabbatini Armando
Division of Thoracic Surgery, Umberto I Regional Hospital, Ancona, Italy.
Ann Thorac Surg. 2007 Aug;84(2):410-6. doi: 10.1016/j.athoracsur.2007.04.019.
The objective of this study was to assess the preoperative and postoperative quality of life of candidates for major lung resection with lung cancer.
In all, 156 consecutive patients (144 lobectomies, 12 pneumonectomies) were prospectively assessed by means of the Short Form-36 Health Survey, version 2, preoperatively and 1 month and 3 months after operation. Serial quality of life scales were compared by repeated measures analysis of variance.
In our series, most quality of life values were reduced compared with the general population. Compared with preoperative values, the physical composite scale was significantly reduced at 1 month (51 versus 45.1, p < 0.0001), and completely recovered at 3 months (51 versus 52.4, p = 0.2), whereas the mental composite scale remained unchanged. All correlation coefficients between these values and forced expiratory volume in 1 second, carbon monoxide lung diffusion capacity, and height reached at stair-climbing test at each evaluation period were below 0.2. With the exception of pneumonectomy patients (who had a significantly lower physical composite scale [p = 0.04]), no significant differences in both physical and mental values were noted in other high-risk subgroups of patients (elderly, coronary artery disease, poor pulmonary function) compared with lower-risk counterparts.
Candidates for lung resection with lung cancer had a worse preoperative quality of life compared with the general population. Quality-of-life measures had poor correlation with forced expiratory volume in 1 second, carbon monoxide lung diffusion capacity, and exercise test performance. Therefore, these functional variables cannot substitute for specific evaluation instruments. Finally, patients traditionally considered at higher risk for lung resection had postoperative physical and emotional quality of life scores similar to those observed in younger and fitter patients.
本研究的目的是评估肺癌患者接受肺叶切除术前和术后的生活质量。
总共对156例连续患者（144例行肺叶切除术，12例行全肺切除术）进行前瞻性评估，采用简短健康调查问卷第2版，在术前、术后1个月和3个月进行评估。通过重复测量方差分析比较系列生活质量量表。
在我们的研究系列中，与一般人群相比，大多数生活质量值降低。与术前值相比，身体综合量表在1个月时显著降低（51对45.1，p<0.0001），在3个月时完全恢复（51对52.4，p = 0.2），而心理综合量表保持不变。在每个评估期，这些值与第1秒用力呼气量、一氧化碳肺扩散能力以及爬楼梯试验中达到的身高之间的所有相关系数均低于0.2。除了全肺切除术患者（其身体综合量表显著较低[p = 0.04]）外，与低风险患者相比，其他高风险亚组患者（老年人、冠状动脉疾病、肺功能差）在身体和心理值方面均未发现显著差异。
与一般人群相比，肺癌肺切除患者术前生活质量较差。生活质量测量与第1秒用力呼气量、一氧化碳肺扩散能力和运动试验表现的相关性较差。因此，这些功能变量不能替代特定的评估工具。最后，传统上被认为肺切除风险较高的患者术后身体和情感生活质量得分与年轻健康患者相似。
