Department of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom.
J Palliat Med. 2010 Sep;13(9):1109-18. doi: 10.1089/jpm.2010.0068.
Little is known about symptom burden and palliative care needs of breathless patients with advanced cancer and chronic obstructive pulmonary disease (COPD).
We aimed to describe and compare symptoms and needs in these two groups in relation to survival.
Cross-sectional study of breathless patients with COPD III/IV or advanced cancer. Data were collected in an interview using the Memorial Symptom Assessment Scale short form (MSAS-SF), the modified Borg Scale, the Hospital Anxiety and Depression Scale, and the Palliative Care Outcome Scale (POS). Follow-up information was collected on survival.
Forty-nine patients with cancer and 60 patients with COPD were recruited. Both groups had similar demographics and a similar high symptom burden: median number of 14 symptoms; most prevalent symptoms in both groups besides breathlessness were drowsiness, lack of energy, cough; median global symptom distress on MSAS-Global Distress Index MSAS-GDI 1.6 in cancer and 1.4 in COPD. HADS depression scores were higher than HADS anxiety scores. Palliative care needs were also similar in both groups. Median survival was 107 days in patients with cancer and 589 days in patients with COPD.
Symptom burden and palliative care needs of breathless patients with severe COPD are considerable and as high as among patients with advanced primary and secondary lung cancer although patients with COPD have a longer survival.
对于晚期癌症和慢性阻塞性肺疾病（COPD）患者的呼吸困难症状负担和姑息治疗需求，了解甚少。
我们旨在描述并比较这两组患者的症状和需求与生存的关系。
对 COPD III/IV 或晚期癌症的呼吸困难患者进行横断面研究。使用简短版纪念症状评估量表（MSAS-SF）、改良 Borg 量表、医院焦虑抑郁量表和姑息治疗结局量表（POS）在访谈中收集数据。收集有关生存的随访信息。
共招募了 49 例癌症患者和 60 例 COPD 患者。两组患者的人口统计学特征相似，且症状负担也相似：14 个症状的中位数；两组中除呼吸困难外最常见的症状为嗜睡、乏力、咳嗽；MSAS 总体痛苦指数 MSAS-GDI 中，癌症患者为 1.6，COPD 患者为 1.4。HADS 抑郁评分高于 HADS 焦虑评分。两组的姑息治疗需求也相似。癌症患者的中位生存期为 107 天，COPD 患者为 589 天。
严重 COPD 呼吸困难患者的症状负担和姑息治疗需求相当高，与晚期原发性和继发性肺癌患者相当，尽管 COPD 患者的生存期更长。
