Amjadi Kayvan, Voduc Nha, Cruysberghs Yves, Lemmens Roel, Fergusson Dean A, Doucette Steve, Noppen Marc
Interventional Endoscopy Clinic and Respiratory Division, University Hospital AZ-VUB, Brussels, Belgium.
Respiration. 2008;76(4):421-8. doi: 10.1159/000152832. Epub 2008 Aug 30.
Interventional bronchoscopic procedures can re-establish airway patency in the majority of individuals suffering from endobronchial obstruction. However, literature provides limited data on the impact of these procedures on the individual's quality of life (QoL).
We evaluated the impact of interventional bronchoscopic procedures aimed at re-establishing airway patency on symptoms and QoL of individuals who do not receive concomitant chemotherapy or radiation therapy.
Over a 6-month period, we prospectively enrolled patients with symptomatic central airway obstruction related to malignancy and performed laser ablation, cryotherapy, and/or airway stenting in order to re-establish airway patency. QoL was evaluated by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire at one day before, 7 days after, and 1 month after procedure. Dyspnea was also assessed by the Borg scale before the procedure and one day after.
Final analysis could be performed on 83% (20/24) of the participants. Improvement in airway diameter was achieved in all patients, and >80% patency was established in 80% (16/20) of the patients. Dyspnea scores had improved in 85% of participants (p = 0.01). Thirteen patients experienced an improvement in QoL, although QoL scores remained stable for the group as a whole.
Endoscopic procedures can effectively reduce dyspnea associated with malignant central airway obstruction, but this may not always translate into improvements in overall QoL. Administration of QoL questionnaires is feasible, and may help identify domains contributing to patient's decline, and thereby improve overall patient care.
介入性支气管镜检查程序可使大多数患有支气管内阻塞的个体重新建立气道通畅。然而，关于这些程序对个体生活质量（QoL）影响的文献资料有限。
我们评估了旨在重新建立气道通畅的介入性支气管镜检查程序对未接受同步化疗或放疗的个体的症状和生活质量的影响。
在6个月的时间里，我们前瞻性地招募了患有与恶性肿瘤相关的有症状中央气道阻塞的患者，并进行了激光消融、冷冻治疗和/或气道支架置入术，以重新建立气道通畅。在手术前一天、手术后7天和手术后1个月，通过欧洲癌症研究与治疗组织生活质量问卷评估生活质量。在手术前和手术后一天，还通过Borg量表评估呼吸困难情况。
最终分析可对83%（20/24）的参与者进行。所有患者的气道直径均有改善，80%（16/20）的患者建立了>80%的通畅率。85%的参与者呼吸困难评分有所改善（p = 0.01）。13名患者的生活质量有所改善，尽管总体生活质量评分保持稳定。
内镜检查程序可有效减轻与恶性中央气道阻塞相关的呼吸困难，但这不一定总能转化为整体生活质量的改善。生活质量问卷的管理是可行的，可能有助于确定导致患者病情下降的因素，从而改善整体患者护理。
