Preoperative management using inhalation therapy for pulmonary complications in lung cancer patients with chronic obstructive pulmonary disease
Preoperative management using inhalation therapy for pulmonary complications in lung cancer patients with chronic obstructive pulmonary disease
复制标题
雾化吸入治疗合并慢性阻塞性肺疾病肺癌患者肺部并发症的术前处理
DOI：
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发表时间：
2017
影响因子：
1.2
通讯作者：
Akira Sato
中科院分区：
文献类型：
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作者：
K. Takegahara;J. Usuda;Tatsuya Inoue;T. Ibi;Akira Sato
本研究旨在探讨围手术期吸入长效β-激动剂(LABA)或长效M受体拮抗剂(LAMA)能否降低肺癌合并慢性阻塞性肺疾病(COPD)患者术后并发症的发生率。方法回顾分析2013年1月至2016年1月在本院行肺切除的COPD患者108例，分析术后并发症(如漏气时间延长、肺炎等)的发生率与长效β-激动剂或长效M受体拮抗剂应用的关系。结果30例COPD患者术后出现并发症(27.8%)，其中14例出现长时间漏气(>7天)，10名患者发展为肺炎。COPD组术后肺部并发症发生率(24/108例，22.2%)明显高于非COPD组(15/224例，6.7%)。在108名COPD患者中，34名患者服用了吸入性支气管扩张剂，如LAMA或LABA；其余74名患者未接受支气管扩张剂治疗。使用LAMA或LABA的患者肺部并发症发生率(3/34例，8.8%)明显低于未经治疗的COPD患者(21/74例，28.4%)。结论对于合并COPD的肺癌患者，术前应用LABA或LABA及戒烟可降低肺切除术后肺部并发症的发生率。雾化吸入LAMA或LABA不仅对围术期护理有用，而且对COPD患者术后的长期生存也有帮助。
ObjectiveThis study aimed to investigate whether perioperative inhalations of long-acting beta-agonists (LABAs) or long-acting muscarinic antagonists (LAMAs) might decrease the incidence of postoperative complications in lung cancer patients with chronic obstructive pulmonary disease (COPD).MethodsWe retrospectively analyzed 108 patients with COPD who underwent pulmonary resections for primary lung cancer at our hospital between January 2013 and January 2016 to determine the association between the incidence of postoperative complications (e.g., prolonged air leakage and pneumonia) and the use of LABAs or LAMAs.ResultsThirty patients with COPD experienced postoperative complications (27.8%): Fourteen patients had prolonged air leakages (more than 7 days), ten patients developed pneumonia. The frequency of these postoperative pulmonary complications was significantly higher among the patients with COPD (24/108 cases, 22.2%), compared with the frequency among non-COPD patients (15/224 cases, 6.7%). Inhaled bronchodilators, such as LAMA or LABA, were prescribed for 34 of the 108 patients with COPD; the remaining 74 patients were not treated with bronchodilators. Pulmonary complications were significant lower among the LAMA or LABA users (3/34 cases, 8.8%) than among the untreated COPD patients (21/74 cases, 28.4%).ConclusionFor lung cancer patients with COPD, preoperative management using LABA or LAMA bronchodilators and smoking cessation can reduce the frequency of postoperative pulmonary complications after surgical lung resection. LAMA or LABA inhalation might be useful for not only perioperative care, but also for the long-term survival of COPD patients after surgery.
影响因子：
9.6
作者：
Zhai, Rihong;Yu, Xiaojin;Christiani, David C.
通讯作者：
Christiani, David C.