Nakamichi Toru, Hashimoto Masaki, Nakamura Akifumi, Kuroda Ayumi, Tanaka Takashi, Takeuchi Jiro, Matsumoto Seiji, Morimoto Takeshi, Kondo Nobuyuki, Domen Kazuhisa, Hasegawa Seiki
Department of Thoracic Surgery, Hyogo College of Medicine, Hyogo, Japan.
Department of Rehabilitation Medicine, Hyogo College of Medicine Hospital, Hyogo, Japan.
Interact Cardiovasc Thorac Surg. 2021 Oct 4;33(4):572-579. doi: 10.1093/icvts/ivab139.
Impact of pleurectomy/decortication (P/D) on quality of life (QOL) is not widely reported. We investigated QOL and lung function after P/D.
A single-centre, retrospective cohort study was performed among patients who underwent P/D for malignant mesothelioma between June 2014 and June 2018 at Hyogo College of Medicine. Data at 4 points before and 3, 6 and 12 months on QOL and lung function were evaluated with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and pulmonary function tests.
Forty-five out of 65 patients completed SF-36. Physical function and role physical decreased from 78 to 65 and 69 to 41 and did not recover. Body pain decreased from 74 to 52. It increased to 62 at 12 months but was lower than before. General health perceptions, vitality and social function decreased from 56 to 49, 50 to 47 and 63 to 50, respectively, but returned to baseline. Role emotional decreased from 75 to 54, then once increased to 63, but decreased again to 58. Mental health tended to improve from 58 to 70. Thirty-eight patients out of 45 completed pulmonary function tests. Forced vital capacity and forced expiratory volume in 1 s decreased from 98% to 61% and 93% to 67% and did not increase. Right-sided surgery or complications was the risk factors of poor lung function but no significant risk factors in QOL.
This study suggests that P/D had an impact on QOL. Despite the lack of recovery in lung function QOL in mental aspects tended to improve, suggesting that pulmonary function tests alone are limited in assessing QOL.
胸膜切除术/纤维板剥脱术(P/D)对生活质量(QOL)的影响尚未得到广泛报道。我们研究了P/D术后的生活质量和肺功能。
对2014年6月至2018年6月在兵库医科大学因恶性间皮瘤接受P/D手术的患者进行了一项单中心回顾性队列研究。使用医学结局研究36项简短健康调查(SF-36)和肺功能测试评估了生活质量和肺功能在术前4个时间点以及术后3、6和12个月的数据。
65例患者中有45例完成了SF-36调查。身体功能和身体角色功能分别从78降至65以及从69降至41,且未恢复。身体疼痛从74降至52。在12个月时升至62,但仍低于术前。总体健康感知、活力和社会功能分别从56降至49、从50降至47以及从63降至50,但恢复到了基线水平。情感角色功能从75降至54,随后一度升至63,但又降至58。心理健康状况倾向于从58改善至70。45例患者中有38例完成了肺功能测试。用力肺活量和1秒用力呼气量分别从98%降至61%以及从93%降至67%,且未增加。右侧手术或并发症是肺功能差的危险因素,但在生活质量方面无显著危险因素。
本研究表明P/D对生活质量有影响。尽管肺功能未恢复,但心理方面的生活质量倾向于改善,这表明仅靠肺功能测试在评估生活质量方面存在局限性。