新兴国家中留置胸膜导管治疗恶性胸腔积液患者的生活质量。

Quality of life in patients with malignant pleural effusion treated with an indwelling pleural catheter in an emerging country.

机构信息

Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.

出版信息

Clinics (Sao Paulo). 2022 Jun 18;77:100063. doi: 10.1016/j.clinsp.2022.100063. eCollection 2022.

DOI:10.1016/j.clinsp.2022.100063

PMID:35728443

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9214818/

Abstract

BACKGROUND

The use of Indwelling Pleural Catheter (IPC) in the care of patients with Malignant Pleural Effusion (MPE) is well established, however studies involving public health systems of low and middle-income countries are still lacking. This study aimed to determine the effect of IPC on the respiratory symptoms and Quality of Life (QoL) of patients with MPE in the setting of a Brazilian public health system.

METHODS

From August 2015 to November 2019, patients with MPE underwent IPC placement and were prospectively followed. QoL and respiratory symptoms were assessed by the EORTC questionnaires (QLQ-30; LC13) and Visual Analogue Scale (VAS), respectively, at pre-treatment, 30 , and 60 days after IPC placement.

RESULTS

56 patients were enrolled with 57 catheters inserted. The mean age was 63 (23‒88) years, of which 17 (30%) were men and 39 (70%) were women. Breast 24 (42%) and lung 21 (37%) were the main primary neoplasms. Cellulitis was the most common complication and all patients recovered with appropriate antimicrobial therapy. QoL did not change significantly over time, however, the VAS showed a significant improvement in dyspnea (+1.2: -0.5; p = 0.001).

CONCLUSION

IPC relieves respiratory symptoms without compromising the QoL, with a low complication rate. It represents a suitable option for patients with MPE and short LE in an emerging country.

摘要

背景

留置胸腔导管（IPC）在恶性胸腔积液（MPE）患者的治疗中已得到广泛应用，但涉及中低收入国家公共卫生系统的研究仍较少。本研究旨在确定 IPC 在巴西公共卫生系统中对 MPE 患者的呼吸症状和生活质量（QoL）的影响。

方法

2015 年 8 月至 2019 年 11 月，对 MPE 患者进行 IPC 置管并进行前瞻性随访。在治疗前、IPC 置管后 30 天和 60 天，分别通过 EORTC 问卷（QLQ-30；LC13）和视觉模拟量表（VAS）评估 QoL 和呼吸症状。

结果

共纳入 56 例患者，共置入 57 根导管。患者平均年龄为 63 岁（23‒88 岁），其中 17 例（30%）为男性，39 例（70%）为女性。原发性肿瘤主要为乳腺癌 24 例（42%）和肺癌 21 例（37%）。蜂窝织炎是最常见的并发症，所有患者均通过适当的抗菌治疗得以恢复。QoL 随时间无显著变化，但 VAS 显示呼吸困难明显改善（+1.2：-0.5；p=0.001）。