Department of General and Thoracic Surgery, University Hospital Schleswig Holstein, Kiel, Germany.
J Palliat Med. 2012 Jan;15(1):37-42. doi: 10.1089/jpm.2011.0149. Epub 2012 Jan 16.
Thoracoscopic pleurodesis is a safe and effective method of palliative care for patients suffering from malignant pleural effusion. Health-related quality of life (QOL) is an important factor in palliative therapy; however, we are not aware of any studies that have examined the QOL of patients following thoracoscopic pleurodesis.
A total of 123 patients underwent thoracoscopic pleurodesis between January 2006 and February 2009. A total of 45 patients agreed to take part at the QOL assessment and were enrolled in our prospective study. In addition to clinical outcome, the patients' QOL data were assessed prior to thoracoscopic pleurodesis and for 12 months after surgery using the European Organization for Research and Treatment of Cancer (EORTC) QLQ C-30 questionnaire. We compared the patients' QOL scores at each time point with their preoperative scores and analyzed these data relative to the scores of a healthy age-matched population.
Due to the advanced clinical status of the patients in our study, the overall median survival time was 7.5 months versus 10.2 months for patients' QOL data. Following discharge from the hospital, most functional scales (with exception of emotional function, p=0.035) did not significantly differ from preoperative scores. Throughout the study period, patients experienced statistically and clinically significant improvements in functional scales. Global health values increased after surgery throughout the entire study period. There was a clear decline in dyspnea upon discharge, followed by a continuous remote increase throughout the subsequent months. QOL of the study population remained lower than that of the healthy cohort.
Our data are consistent with clinical findings that pleurodesis decreases respiratory symptoms, but does not alleviate impairments in the patient's general condition.
胸腔镜胸膜固定术是治疗恶性胸腔积液患者的一种安全有效的姑息治疗方法。健康相关生活质量（QOL）是姑息治疗的一个重要因素；然而，我们不知道有任何研究检查过胸腔镜胸膜固定术后患者的 QOL。
2006 年 1 月至 2009 年 2 月期间，共有 123 名患者接受了胸腔镜胸膜固定术。共有 45 名患者同意在 QOL 评估中参与，并被纳入我们的前瞻性研究。除了临床结果外，还在胸腔镜胸膜固定术之前以及手术后 12 个月使用欧洲癌症研究与治疗组织（EORTC）QLQ C-30 问卷评估患者的 QOL 数据。我们将每个时间点的患者 QOL 评分与术前评分进行了比较，并将这些数据与健康年龄匹配人群的评分进行了分析。
由于我们研究中的患者临床状况较为严重，总体中位生存时间为 7.5 个月，而患者 QOL 数据为 10.2 个月。出院后，大多数功能量表（情绪功能除外，p=0.035）与术前评分没有显著差异。在整个研究期间，患者在功能量表方面经历了统计学和临床上显著的改善。全球健康值在手术后整个研究期间均有所增加。出院时呼吸困难明显减轻，随后在随后的几个月中持续增加。研究人群的 QOL 仍低于健康队列。
我们的数据与临床发现一致，即胸膜固定术可减轻呼吸症状，但不能缓解患者一般状况的损害。
