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影响非小细胞肺癌肺切除术后功能运动能力的因素。

Factors Influencing Functional Exercise Capacity After Lung Resection for Non-Small Cell Lung Cancer.

机构信息

Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan.

出版信息

Integr Cancer Ther. 2020 Jan-Dec;19:1534735420923389. doi: 10.1177/1534735420923389.

Abstract

We investigated, in patients who underwent lung resection for non-small cell lung cancer (NSCLC), the magnitude of early limitation in functional exercise capacity and the associations with pre- and postoperative factors. Consecutive patients with preoperative clinical stage I to IIIA NSCLC who underwent lung resection were prospectively enrolled. We measured functional exercise capacity (6-minute walk distance [6MWD]) and skeletal muscle strength (handgrip [HF] and quadriceps force [QF]) within 2 days prior to surgery and on day 7 postoperatively. Two hundred eighteen participants were recruited (median age 69 years) of whom 49 developed postoperative complications (POCs). 6MWD was markedly decreased (514 m vs 469 m, < .001); HF and QF were slightly decreased following surgery. Multiple linear regression showed that preoperative vital capacity ( < .01), QF ( < .05), the duration of chest tube drainage ( < .001), and presence of POCs ( < .05) were significant predictors. However, intraoperative factors were not significantly associated with the decline in 6MWD. These results suggest that patients with preoperative impairments in pulmonary function and muscle strength, and those who require prolonged chest tube drainage or develop POCs are likely to have impaired exercise capacity. Therefore, individual assessment and follow-up of patients with such factors is indicated.

摘要

我们研究了非小细胞肺癌(NSCLC)患者肺切除术后早期功能运动能力受限的程度及其与术前和术后因素的关系。连续招募了术前临床分期 I 期至 IIIA 期 NSCLC 患者,接受肺切除术。我们在术前 2 天内和术后第 7 天测量了功能运动能力(6 分钟步行距离[6MWD])和骨骼肌力量(手握力[HF]和股四头肌力量[QF])。218 名参与者入选(中位年龄 69 岁),其中 49 名发生术后并发症(POC)。6MWD 明显下降(514m 与 469m, <.001);术后 HF 和 QF 略有下降。多元线性回归显示,术前肺活量( <.01)、QF( <.05)、胸腔引流管放置时间( <.001)和 POC 存在( <.05)是显著预测因素。然而,术中因素与 6MWD 下降无显著相关性。这些结果表明,术前肺功能和肌肉力量受损、需要长时间胸腔引流管或发生 POC 的患者可能运动能力受损。因此,需要对有此类因素的患者进行个体评估和随访。

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