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肺切除术后持续咳嗽:小问题,大障碍。

Persistent cough after pulmonary resection: Minor issue, major hurdle.

作者信息

Sun Xuefeng, Lan Zihua, Shi Qiuling, Wu Hansheng, Lu Guojie, Qiu Yuan, Tang Yong, Qiao Guibin

机构信息

The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.

Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, China.

出版信息

Heliyon. 2024 May 18;10(10):e31338. doi: 10.1016/j.heliyon.2024.e31338. eCollection 2024 May 30.

Abstract

BACKGROUND

Persistent cough is one of the most common complications following pulmonary resection, that impairs patients' quality of life and prolongs recovery time. However, a comprehensive review of persistent cough after pulmonary resection (CAP) has not been performed.

METHODS

A literature search of PubMed/MEDLINE, Web of Science, and Embase database was conducted for persistent-CAP up to June 2023. Subsequent qualitative systematic review focused on definition, risk factors, prevention, and treatment of persistent-CAP.

RESULTS

Persistent-CAP stands as a prevalent postoperative complication subsequent to pulmonary resection procedures. with an incidence of 24.4-55.0 %. Although persistent-CAP has a minor impact on survival, this condition is of critical importance because it presents a major hurdle in recovery after surgery. In this review, we proposed a systemic definition for persistent-CAP based on available evidence and our own data. Several assessment tools used to assess severity of persistent-CAP are also introduced. Risk factors associated with persistent-CAP are explored, including surgical approaches, resection extent, surgical site, lymph node dissection, postoperative gastroesophageal acid reflux, tracheal intubation anesthesia, preoperative comorbidity, and sex among others. Surgical and anesthesia preventions targeting risk factors to prevent persistent-CAP are elaborated. A number of studies have shown that a multidisciplinary approach can effectively relieve persistent-CAP.

CONCLUSIONS

Although the mechanisms underlying persistent-CAP are still unclear, existing studies demonstrated that persistent-CAP is related to surgical and anesthesia factors. Therefore, in the future, prevention and treatment should be developed based on risk factors to overcome the hurdle of persistent-CAP.

摘要

背景

持续性咳嗽是肺切除术后最常见的并发症之一,会损害患者的生活质量并延长恢复时间。然而,尚未对肺切除术后持续性咳嗽(CAP)进行全面综述。

方法

截至2023年6月,在PubMed/MEDLINE、科学网和Embase数据库中检索关于持续性CAP的文献。随后进行的定性系统综述聚焦于持续性CAP的定义、危险因素、预防和治疗。

结果

持续性CAP是肺切除术后常见的术后并发症,发病率为24.4%-55.0%。尽管持续性CAP对生存率影响较小,但该病症至关重要,因为它是术后恢复的主要障碍。在本综述中,我们基于现有证据和自身数据提出了持续性CAP的系统性定义。还介绍了几种用于评估持续性CAP严重程度的评估工具。探讨了与持续性CAP相关的危险因素,包括手术方式、切除范围、手术部位、淋巴结清扫、术后胃食管酸反流、气管插管麻醉、术前合并症和性别等。阐述了针对危险因素预防持续性CAP的手术和麻醉预防措施。多项研究表明,多学科方法可有效缓解持续性CAP。

结论

尽管持续性CAP的潜在机制仍不清楚,但现有研究表明,持续性CAP与手术和麻醉因素有关。因此,未来应基于危险因素制定预防和治疗措施,以克服持续性CAP这一障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c03/11141375/3d041ef12f37/ga1.jpg

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