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长效支气管扩张剂在肺癌合并慢性阻塞性肺疾病患者围手术期应用对术后肺功能和生活质量的影响:一项随机对照研究的初步结果。

Efficacy of perioperative administration of long-acting bronchodilator on postoperative pulmonary function and quality of life in lung cancer patients with chronic obstructive pulmonary disease. Preliminary results of a randomized control study.

机构信息

Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

出版信息

Surg Today. 2010 Oct;40(10):923-30. doi: 10.1007/s00595-009-4196-1. Epub 2010 Sep 25.

Abstract

PURPOSE

Long-acting bronchodilators are recommended as a first-line treatment for chronic obstructive pulmonary disease (COPD), although their effects for postoperative lung cancer patients with COPD are still not well known. A prospective randomized trial was used to examine the efficacy of bronchodilators on postoperative pulmonary function and quality of life (QOL).

METHODS

Twenty lung cancer patients with COPD who had lobectomies were randomized. A control group (n = 10) did not receive bronchodilators. An experimental group (n = 10) received tiotropium and salmeterol. Patients were divided into two COPD grades: stage I COPD and stage II-III COPD. Results for pulmonary function, 6-minute walking test, and the St. George's Respiratory Questionnaire (SGRQ) were compared. Diaphragmatic motion on dynamic magnetic resonance imaging was also analyzed.

RESULTS

The patient demographics were similar in the two groups. Except for pulmonary function results at 2 weeks, no other parameters were significantly different. However, in stage II-III COPD, forced expiratory volume in 1 second, forced vital capacity, inspiratory capacity, the total score of the SGRQ, and diaphragmatic motion in the experimental group (n = 5) were significantly better than those in the control group (n = 4) at various time points (all P < 0.05).

CONCLUSION

The daily inhalation of bronchodilators was effective for maintaining the respiratory function and QOL in lung cancer patients with moderate to severe COPD.

摘要

目的

长效支气管扩张剂被推荐作为慢性阻塞性肺疾病(COPD)的一线治疗药物,尽管它们在 COPD 术后肺癌患者中的效果仍不清楚。一项前瞻性随机试验用于研究支气管扩张剂对术后肺功能和生活质量(QOL)的疗效。

方法

20 例接受肺叶切除术的 COPD 肺癌患者被随机分组。对照组(n = 10)未接受支气管扩张剂治疗。实验组(n = 10)接受噻托溴铵和沙美特罗治疗。患者分为 COPD 两个阶段:I 期 COPD 和 II-III 期 COPD。比较肺功能、6 分钟步行试验和圣乔治呼吸问卷(SGRQ)的结果。还分析了膈肌在动态磁共振成像上的运动。

结果

两组患者的人口统计学特征相似。除了 2 周时的肺功能结果外,其他参数均无显著差异。然而,在 II-III 期 COPD 中,实验组(n = 5)的 1 秒用力呼气量、用力肺活量、吸气量、SGRQ 总分和膈肌运动在各个时间点均显著优于对照组(n = 4)(均 P < 0.05)。

结论

每日吸入支气管扩张剂对维持中重度 COPD 肺癌患者的呼吸功能和生活质量有效。

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