肺结核损毁肺患者手术后的长期随访。
Long-term follow-up of tuberculosis-destroyed lung patients after surgical treatment.
机构信息
Department of Cellular and Molecular Biology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, No 9, Bei guan Street, Tong Zhou District, Beijing, 101149, People's Republic of China.
Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Science and Technology Office, Capital Medical University, Beijing, People's Republic of China.
出版信息
BMC Pulm Med. 2022 Sep 14;22(1):346. doi: 10.1186/s12890-022-02139-z.
BACKGROUND
To monitor dypsnea and mortality at 5 and 10 years, respectively, after surgical treatment of tuberculosis-destroyed lung (TDL) patients.
METHODS
TDL patients treated surgically at Beijing Chest Hospital from November 2007 to June 2019 were monitored in this observational study. Follow-up assessments of respiratory function indicators and survival conducted 5 and 10 years post-surgery led to patient grouping based on mMRC score into a dyspnea group (mMRC ≥ 1) and a non-dyspnea group (mMRC = 0). Cox regression analysis detected effects of patient demographics, clinical characteristics, surgical factors and respiratory function on 5 year post-surgical survival.
RESULTS
By study completion (June 30, 2020), 32 of 104 patients were lost and 72 completed follow-up for a study total of 258.9 person-years. 45 patients (62.5%, 45/72) had mMRC scores of 0, while 12 (16.7%, 12/72), 21 (36.2%, 21/58) and 27 (60.0%, 27/45) patients exhibited dyspnea by 1, 3 and 5 years post-surgery, respectively. Low lung carbon monoxide diffusion score (DLCO% pred) and scoliosis contributed to dyspnea occurrence.
CONCLUSIONS
Most TDL patients lacked subjective dyspnea signs post-surgery, while dyspnea rates increased with time. Preoperative low lung diffusion function and Scoliosis were associated with factors for postoperative dyspnea. Surgical treatment increased TDL patient survival overall.
背景
分别监测外科治疗肺结核损毁肺（TDL）患者后 5 年和 10 年的呼吸困难和死亡率。
方法
本观察性研究监测了 2007 年 11 月至 2019 年 6 月在北京胸科医院接受外科治疗的 TDL 患者。术后对呼吸功能指标和生存情况进行了 5 年和 10 年的随访评估，根据 mMRC 评分将患者分为呼吸困难组（mMRC≥1）和非呼吸困难组（mMRC=0）。Cox 回归分析检测了患者人口统计学、临床特征、手术因素和呼吸功能对术后 5 年生存的影响。
结果
研究完成时（2020 年 6 月 30 日），104 例患者中有 32 例失访，72 例完成随访，共 258.9 人年。45 例（62.5%，45/72）患者的 mMRC 评分为 0，而 12 例（16.7%，12/72）、21 例（36.2%，21/58）和 27 例（60.0%，27/45）患者分别在术后 1、3 和 5 年出现呼吸困难。低肺一氧化碳弥散量（DLCO%pred）和脊柱侧凸与呼吸困难的发生有关。
结论
大多数 TDL 患者术后缺乏主观呼吸困难体征，但呼吸困难发生率随时间增加。术前低肺弥散功能和脊柱侧凸与术后呼吸困难的发生有关。手术治疗总体上提高了 TDL 患者的生存率。
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