无创通气对COPD合并肺癌患者治疗效果和生存情况的影响

Efficacy of Noninvasive Ventilation for Patients with COPD and Lung Cancer and Its Effect on Quality of Life

目的探讨无创通气在COPD合并肺癌患者临床治疗中的应用价值,评价其对患者治疗效果和生活质量的影响。方法回顾性分析102例COPD合并肺癌患者的临床资料,根据患者的治疗方法分为观察组和对照组。对照组有48例患者,采用常规治疗;观察组患者有54例,在常规治疗的基础上加以无创通气治疗。对2组患者治疗后2周、1个月和6个月的疗效相关指标进行分析性比较,以及对2组患者治疗前后的FACT-L生存质量评分进行分析。结果在治疗2周时,2组患者的治疗效果有统计学差异(P<0.05);与对照组相比,观察组患者的血气指标正常、呼吸困难消失、精神及食欲改善、部分生活自理等指标均有显著优势(P<0.05)。在治疗1个月时,2组患者生存质量均有不同程度的改善,其中体重无明显变化、精神及食欲改善、部分生活自理等指标方面,观察组显著优于对照组(P<0.05)。在治疗6个月时,观察组患者肺性脑病情况发生率显著低于对照组(P<0.05)。与治疗前相比较,对照组患者生理状况、功能状况和FACT-L生存质量总分显著下降(P<0.05),社会和家庭状况无显著变化(P>0.05)。观察组患者生理状况、功能状况、社会和家庭状况以及FACT-L生存质量总分均显著上升(P<0.05)。结论无创通气在提高COPD合并肺癌患者特别是老年患者的治疗疗效和改善患者生理状况、功能状况以及生存质量等方面有非常显著的效果。

Objective To study the application value of noninvasive ventilation for patients with COPD and lung cancer , and evaluate its therapeutic effect on quality of life of patients.Methods Retrospective analysis of clinical data of 102 patients with COPD and lung cancer were conducted ,and they were divided into the observation group and the control group ,the control group（48 cases）received conventional treatment,and the observation group（54 cases）received noninvasive ventilation treatment on the basis of conventional treatment.The relevant indicators of efficacy of the 2 groups 2 weeks,1 month and 6 months after treatment were analyzed,and FACT-L life quality score of the 2 groups were analyzed.Results After 2 weeks of treatment,the curative effect of the 2 groups had significant differences （P〈0.05）;Compared with the control group ,blood gas index was nor-mal ,dyspnea disappeared ,spirit and appetite improvement ,part self-care ability had significant advantage in the observation group （P〈0.05）.After 1 month of treatment,quality of life of the 2 groups of patients had different degrees of improvement ,weight had no significant change ,spirit and appetite improvement ,part self-care ability in the observation group were significantly better than the control group（P〈0.05）.After 6 months of treatment,pulmonary encephalopathy of the observation group was significantly lower than the control group（P〈0.05）.Compared with before treatment,functional status,physical activity and FACT-L quality of life scores in the control group decreased significantly after treatment （P〈0.05）,physiological status,functional status,social and family status and FACT-L quality of life scores in the observation group significantly increased after treatment （P〈0.05）.Af-ter treatment,the control group had no significant change in social and family status compared with before treatment （P〉0.05）.Conclusion Noninvasive ventilation for COPD with lung cancer patients ,especially elderly patients ,is effective,and can signifi-cantly improve quality of life ,function and survival of patients.