Ewer M S, Ali M K, Atta M S, Morice R C, Balakrishnan P V
JAMA. 1986 Dec 26;256(24):3364-6.
The prognosis of lung cancer patients who are not candidates for surgery is usually poor. The unfavorable natural history of respiratory failure in this group of patients has been suggested as a causative factor. We analyzed the outcome of 46 consecutive patients with primary lung cancer on whom mechanical ventilators were utilized. Although seven patients were ultimately weaned and survived for at least 24 hours, three of them subsequently died prior to discharge from the hospital. The remaining 39 patients died while using the ventilator. Patient age, tumor cell type, and the etiology of respiratory failure were not significantly different between the weaned and unweaned populations. A difference was noted in the duration of mechanical ventilation: none of the patients who could be weaned required mechanical ventilation for more than six days (range, two to six days). Respiratory failure in the nonsurgical lung cancer patient carries a poor prognosis, and selection of patients for mechanical ventilation should be conservative.
不适合手术的肺癌患者预后通常较差。这组患者呼吸衰竭不利的自然病程被认为是一个致病因素。我们分析了连续46例使用机械通气的原发性肺癌患者的结局。尽管7例患者最终成功脱机并存活至少24小时，但其中3例随后在出院前死亡。其余39例患者在使用呼吸机期间死亡。脱机和未脱机人群之间的患者年龄、肿瘤细胞类型和呼吸衰竭病因无显著差异。机械通气持续时间存在差异：所有能够脱机的患者机械通气时间均不超过6天（范围为2至6天）。非手术肺癌患者的呼吸衰竭预后较差，选择患者进行机械通气应持保守态度。
