Sawada Shigeki, Suehisa Hiroshi, Yamashita Motohiro
Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, 160 Kou Minamiumemotomachi, Matsuyama, Ehime, 791-0280, Japan.
Gen Thorac Cardiovasc Surg. 2012 May;60(5):285-8. doi: 10.1007/s11748-011-0910-1. Epub 2012 Mar 28.
Patients undergoing pulmonary resection often suffer from a dry, hacking cough, which is usually refractory to opioid cough suppressors such as codeine. The cough is often painful and impairs the quality of life of the patients. The efficacy of an inhaled corticosteroid plus β2-agonist against the persistent cough after pulmonary resection was evaluated in this study.
We enrolled 21 patients in this prospective study of the efficacy of an inhaled corticosteroid plus β2-agonist against persistent cough following pulmonary resection. After baseline evaluation of the severity of the postoperative persistent cough using a visual analog scale (VAS), treatment with an inhaled corticosteroid plus β2-agonist was initiated and continued for 2 weeks. At the end of the 2 weeks, the cough severity was evaluated again using a VAS.
The median grade of cough on the VAS before the start of the inhaled treatment was 4 (range 3-8). At the end of 2 weeks of treatment with an inhaled corticosteroid plus β2 agonist, the median grade of cough on the VAS decreased from 4 to 1 (range 0-4). As an adverse effect of the inhalation, hoarseness was observed in one patient, which disappeared promptly after discontinuing the inhalations.
Treatment with an inhaled corticosteroid plus β2 agonist appeared to be highly effective, without severe adverse effects, against the persistent cough suffered by patients after pulmonary resection.
接受肺切除术的患者常出现干咳、呛咳,通常对可待因等阿片类镇咳药无效。这种咳嗽常很痛苦,会损害患者的生活质量。本研究评估了吸入性糖皮质激素加β2受体激动剂对肺切除术后持续性咳嗽的疗效。
我们招募了21例患者参与这项前瞻性研究,以评估吸入性糖皮质激素加β2受体激动剂对肺切除术后持续性咳嗽的疗效。使用视觉模拟量表(VAS)对术后持续性咳嗽的严重程度进行基线评估后,开始使用吸入性糖皮质激素加β2受体激动剂治疗,并持续2周。在2周结束时,再次使用VAS评估咳嗽严重程度。
吸入治疗开始前,VAS上咳嗽的中位评分为4分(范围3 - 8分)。在使用吸入性糖皮质激素加β2受体激动剂治疗2周结束时,VAS上咳嗽的中位评分从4分降至1分(范围0 - 4分)。作为吸入治疗的不良反应,1例患者出现声音嘶哑,在停止吸入后迅速消失。
吸入性糖皮质激素加β2受体激动剂治疗对肺切除术后患者的持续性咳嗽似乎非常有效,且无严重不良反应。