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肺切除术 1 年后的生存和生活质量。

Survival and quality of life at least 1 year after pneumonectomy.

机构信息

Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.

出版信息

J Thorac Cardiovasc Surg. 2012 Nov;144(5):1139-43. doi: 10.1016/j.jtcvs.2012.07.083.

Abstract

OBJECTIVE

Quality of life after pulmonary resection is becoming an increasingly important part of the conversation between patients and surgeons. Pneumonectomy is often called a disease. The objective of this study was to assess the physical and mental aspects of patients' quality of life at least 1 year after pneumonectomy.

METHODS

Quality of life was ascertained using the Short Form-12 (SF-12) survey on a consecutive series of patients who were at least 1 year postoperative from a pneumonectomy. Both the physical and mental component scores of the quality-of-life survey were obtained and compared.

RESULTS

There were 152 patients who underwent pneumonectomy between January 1997 and December 2010 by the same surgeon (104 for non-small cell lung cancer); 111 patients met the eligibility criteria. Mean survival was 3.4 years and the overall 5-year Kaplan-Meier survival was 38%. Responses to the quality-of-life survey were obtained in 108 of 111 patients (98%) who were at least 1 year postoperative. The overall quality-of-life score was comparable with that of the healthy population and patients with chronic diseases. The mean physical component score was significantly lower than that of the healthy population score (P = .04); the mental quality-of-life score was higher than those for patients with certain chronic diseases such as liver or kidney disease (P = .05). After multivariate analysis, only age remained a significant predictor of the physical component score.

CONCLUSIONS

Pneumonectomy is tolerated in carefully selected patients. The physical quality-of-life score 1 year after resection is significantly lower than the average population, yet the mental score in these patients is higher. Future studies on quality of life should be considered for all medical therapies, and stratification of the mental score from the physical score should be reported.

摘要

目的

肺切除术后的生活质量正成为患者与外科医生交流的一个越来越重要的部分。肺切除术通常被称为一种疾病。本研究的目的是评估至少在肺切除术后 1 年患者生活质量的身心方面。

方法

使用简短形式-12(SF-12)调查对至少在肺切除术后 1 年的连续系列患者进行生活质量评估。获得并比较生活质量调查的身体和心理成分评分。

结果

1997 年 1 月至 2010 年 12 月,由同一位外科医生进行了 152 例肺切除术(104 例为非小细胞肺癌);111 例符合入选标准。平均生存时间为 3.4 年,总体 5 年 Kaplan-Meier 生存率为 38%。至少在肺切除术后 1 年的 111 例患者中的 108 例(98%)获得了生活质量调查的回复。整体生活质量评分与健康人群和患有慢性疾病的人群相当。平均身体成分评分明显低于健康人群评分(P =.04);精神生活质量评分高于患有某些慢性疾病(如肝脏或肾脏疾病)的患者(P =.05)。多元分析后,只有年龄仍然是身体成分评分的显著预测因素。

结论

在仔细选择的患者中,肺切除术可以耐受。切除后 1 年的身体生活质量评分明显低于普通人群,但这些患者的精神评分更高。应考虑对所有医疗治疗进行生活质量研究,并报告身体评分和精神评分的分层。

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