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[支气管肺癌肺切除术后的生活质量]

[Quality of life after pneumonectomy for bronchial carcinoma].

作者信息

Fiedler R, Neef H, Hennig H, Rosendahl W, Lautenschläger C

机构信息

Klinik für Innere Medizin II, Martin-Luther-Universität Halle-Wittenberg.

出版信息

Zentralbl Chir. 1997;122(5):327-31.

PMID:9334092
Abstract

UNLABELLED

Quality of life measurements gained increasing importance in the last years. After lung tissue reducing interventions for bronchogenic carcinoma quality of life measurements play an important role, since quality of life can be decisively influenced by post-operative reduced lung function. On the basis of postoperative physical symptoms and lung function the restriction of quality of life after pneumonectomy should be analyzed with respect to intervention and adjuvant therapy, 36 patients with an average age of 61 years were followed up by ambulatory oncological care for 40 months (median) after operation and lung function as well as quality of life were measured by self assessment index QLQ- C 30 of EORTC.

RESULTS

Beside physical symptoms (increasing of dyspnea by 61.1% and pain by 30.6% after pneumonectomy as compared to preoperative values) the significant reduced lung function (IVC by 33.5%, FEV 1 by 27.1%) and the QL-measurement showed the greatest restrictions, latter in "Physical functioning" by 27.2%, in "Role functioning" by 45.8% and in "Global health status/ Quality of life" by 45.6%. The symptoms "Fatigue" (Score 39.8), "Dyspnea" (50,9), "Pain" (29.6) and "Sleep disturbance" (35.2; max. score 100 = high frequency) were most often found. Further adjuvant therapy (at least 6 months after completion) in 11 patients and the type of pneumonectomy (right-side: n = 11, left-side: n = 25) did not result in additional significant reduction of lung function and of single quality of life dimensions, except that "Dyspnea" in patients with right-sided pneumonectomy (66.7) was significantly more frequent than in patients with left-sided pneumonectomy (44.0).

CONCLUSIONS

In this study the restricted quality of life after pneumonectomy was mainly caused by reduction of cardiopulmonary function (reduced lung function by loss of parenchyma). Adjuvant therapy reduced neither lung function nor quality of life. Compared to quality of life measurements after lung resection [17] quality of life after pneumonectomy didn't worse.

摘要

未标注

近年来,生活质量测量变得越来越重要。对于支气管源性肺癌进行肺组织切除术后,生活质量测量起着重要作用,因为术后肺功能下降会对生活质量产生决定性影响。基于术后身体症状和肺功能,应从干预措施和辅助治疗方面分析肺切除术后生活质量的受限情况。36例平均年龄61岁的患者在术后接受门诊肿瘤护理随访40个月(中位数),通过欧洲癌症研究与治疗组织(EORTC)的自我评估指标QLQ-C 30测量肺功能和生活质量。

结果

除身体症状(肺切除术后呼吸困难较术前增加61.1%,疼痛增加30.6%)外,肺功能显著下降(肺活量下降33.5%,第一秒用力呼气容积下降27.1%),生活质量测量显示出最大程度的受限,后者在“身体功能”方面下降27.2%,“角色功能”方面下降45.8%,“总体健康状况/生活质量”方面下降45.6%。最常出现的症状是“疲劳”(得分39.8)、“呼吸困难”(50.9)、“疼痛”(29.6)和“睡眠障碍”(35.2;最高分100 = 高频)。11例患者接受进一步辅助治疗(至少在完成治疗后6个月)以及肺切除术类型(右侧:n = 11,左侧:n = 25),除右侧肺切除患者的“呼吸困难”(66.7)比左侧肺切除患者(44.0)更频繁外,未导致肺功能和单个生活质量维度的进一步显著下降。

结论

在本研究中,肺切除术后生活质量受限主要是由于心肺功能下降(肺实质丧失导致肺功能降低)。辅助治疗既未降低肺功能也未降低生活质量。与肺切除术后的生活质量测量结果相比[17],肺切除术后的生活质量并未更差。

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