慢性阻塞性肺疾病合并支气管肺癌的临床诊断研究

Clinical diagnostic research of chronic obstructive pulmonary disease complicated with bronchogenic carcinoma

目的探讨慢性阻塞性肺疾病(COPD)与支气管肺癌的临床关系,为临床早期诊断和治疗提供依据。方法 54例COPD合并支气管肺癌患者作为观察组,同期54例单纯肺癌患者作为对照组,比较两组患者临床症状和体征、病理类型及治疗方法的差异。结果两组患者干咳、声音嘶哑、胸膜腔积液及骨痛例数比较差异均无统计学意义(P>0.05),观察组发热、胸痛、痰中带血、呼吸困难及肺不张例数均显著多于对照组(P<0.05);两组鳞癌病理类型比较差异无统计学意义(P>0.05),腺癌、小细胞癌及其他非小细胞癌类型,两组比较差异有统计学意义(P<0.05);观察组以非手术治疗为主,对照组以手术治疗为主。结论 COPD合并支气管肺癌的临床症状缺乏特异性,COPD患者出现胸痛、咯血、呼吸困难或伴肺不张、胸腔积液等影像学表现时,应高度警惕合并肺癌可能,尽早进行初筛检查。

ObjectiveTo investigate the clinical relationship between chronic obstructive pulmonary disease （COPD） and bronchogenic carcinoma, in order to provide reference for early clinical diagnosis and treatment.MethodsThere were 54 patients of COPD complicated with bronchogenic carcinoma as observation group, and another 54 patients with lung cancer alone as control group. Comparisons were made on the clinical symptoms, signs, pathological types and treatment methods between the two groups.ResultsThe differences of tussiculation, hoarseness, pleural effusion, and ostealgia cases between the two groups had no statistical significance （P〉0.05）. The observation group had much more cases of fever, chest pain, blood-stained sputum, dyspnea, and pulmonary atelectasis than the control group （P〈0.05）. There was no statistically significant difference of squamous carcinoma pathological type between the two groups （P〉0.05）. The difference of adenocarcinoma, small cell carcinoma, and non small cell carcinoma had statistical significance between the two groups （P〈0.05）. The observation group was treated mainly by non-surgical method, while the control group received surgical treatment.ConclusionThe clinical characteristics of COPD combined with bronchogenic carcinoma lacks of specificity. The imaging manifestations of chest pain, hemoptysis, dyspnea, pulmonary atelectasis, and pleural effusion of COPD patients show the possibility of complicated lung cancer, and early screening examination is necessary.