Lakkadsha Tasneem M, Yadav Vaishnavi, Jain Moli, Lalwani Shivani, Saifee Sakina, Kaderi Abdeali Saif A
Physiotherapy, Datta Meghe Institute of Medical Science, Wardha, IND.
Physiotherapy, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2022 Aug 30;14(8):e28580. doi: 10.7759/cureus.28580. eCollection 2022 Aug.
Adenocarcinoma of the lung along with malignant pleural effusion is an autonomous predictor of decreased survival, thus the main focus of the clinician should be on palliative care. In this case report, we describe chemotherapy, palliative care physiotherapy, and the necessary pulmonary rehabilitation approaches that were used for our patient. It offers a path to treatment planning, with a day-wise protocol aimed at alleviating the patient's symptoms. The patient came to the respiratory medicine department with complaints of severe cough with mucoid expectoration, breathlessness, and generalized weakness; on examination, the patient was tachypneic, tachycardic, and had grade 1 clubbing. His CT scan and chest radiography revealed wide opacity covering most of the right lung, suggesting pleural effusion. When the pleural fluid was examined, it was hemorrhagic and malignant. Thus, he was diagnosed with adenocarcinoma of the lung. A few days later, the patient was referred to a respiratory physiotherapist, who assessed him and recommended a palliative care program and pulmonary rehabilitation. On the day of assessment, the patient was evaluated using various outcome measures, the same measures were again evaluated on the day of discharge and follow-up. These outcome measures revealed significant improvements in cough severity, breathlessness, depression, anxiety, pulmonary capacities, incision site pain, weakness, and overall quality of life. Hence, it is reasonable to conclude that a well-planned pulmonary rehabilitation and palliative care program will improve the patient's respiratory, musculoskeletal, and psychological manifestations during his remaining days.
伴有恶性胸腔积液的肺癌是生存率降低的一个独立预测因素,因此临床医生的主要关注点应放在姑息治疗上。在本病例报告中,我们描述了用于我们患者的化疗、姑息治疗物理疗法以及必要的肺康复方法。它提供了一条治疗规划路径,有一个按日制定的方案,旨在缓解患者症状。该患者因严重咳嗽伴黏液痰、呼吸急促和全身无力前来呼吸内科就诊;检查时,患者呼吸急促、心动过速,并有1级杵状指。他的CT扫描和胸部X线检查显示右肺大部分区域有广泛的模糊影,提示胸腔积液。对胸腔积液进行检查时,发现其为血性且呈恶性。因此,他被诊断为肺癌。几天后,该患者被转介给一位呼吸物理治疗师,后者对他进行了评估,并推荐了一个姑息治疗方案和肺康复计划。在评估当天,使用各种结局指标对患者进行了评估,在出院日和随访时再次评估了相同的指标。这些结局指标显示,患者在咳嗽严重程度、呼吸急促、抑郁、焦虑、肺功能、切口部位疼痛、虚弱和总体生活质量方面有显著改善。因此,有理由得出结论,一个精心规划的肺康复和姑息治疗方案将在患者剩余的日子里改善其呼吸、肌肉骨骼和心理表现。
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