合并慢性阻塞性肺疾病对非小细胞肺癌患者术后心肺并发症和生活质量的影响

Effects of chronic obstructive pulmonary disease on postoperative cardiopulmonary complications and quality of life in patients with non-small cell lung cancer

目的:探讨合并慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)对非小细胞肺癌(non-small cell lung cancer,NSCLC)患者术后心肺并发症和生活质量的影响。方法:回顾性分析2018年10月至2021年5月在三亚市人民医院肿瘤外科成功接受微创手术治疗的122例NSCLC患者相关资料,依据术后2周内是否发生心肺并发症,分成并发症组(n=34)与无并发症组(n=88)。依据术前是否合并COPD,分成单纯NSCLC组(n=85)与合并COPD组(n=37)。院后首次复诊时均完成癌症患者生命质量量表(Quality of Life Scale-30,QLQ-C30)评价,采用单因素和多因素logistic回归模型重点分析合并COPD与NSCLC患者术后发生心肺并发症的关系。结果:并发症组年龄、吸烟史、合并COPD、术前血红蛋白(hemoglobin,Hb)水平均高于无并发症组(P<0.05)。合并COPD组心肺并发症发生率40.54%明显高于单纯NSCLC组22.35%(P<0.05),QLQ-C30量表5个功能维度得分均显著低于单纯NSCLC组(P<0.05)。Logistic回归分析显示:合并COPD(OR=1.492,95%CI:1.134~2.608)是NSCLC患者术后发生心肺并发症的独立危险因素(P<0.05)。结论:NSCLC合并COPD患者术后生活质量明显偏低,且合并COPD会增加NSCLC术后心肺并发症的发生风险。

Objective:To investigate the effect of chronic obstructive pulmonary disease(COPD)on postoperative cardiopulmonary complications and quality of life in patients with non-small cell lung cancer(NSCLC).Methods:The data of 122 patients with NSCLC who successfully underwent minimally invasive surgery in the tumor surgery of Sanya People’s Hospital from October 2018 to May 2021 were analyzed retrospectively.According to whether cardiopulmonary complications occurred within 2 weeks after operation,they were divided into a complication group(n=34)and a non-complication group(n=88).According to whether COPD was combined before operation,they were divided into a simple NSCLC group(n=85)and a combined COPD group(n=37).The Quality of Life Scale-30(QLQ-C30)for cancer patients was completed at the first follow-up visit.Univariate and multivariate logistic regression models were used to analyze the relationship between COPD and postoperative cardiopulmonary complications in patients with NSCLC.Results:The age,smoking history,COPD,and preoperative hemoglobin(Hb)level in the complication group were higher than those in the non-complication group(P<0.05).The incidence of cardiopulmonary complications in the Combined COPD group was 40.54%,which was significantly higher than 22.35%in the simple NSCLC group(P<0.05);the scores of five functional dimensions of QLQ-C30 scale were significantly lower than those in the simple NSCLC group(P<0.05).Logistic regression analysis showed that COPD(OR=1.492,95%CI:1.134-2.608)was an independent risk factor for postoperative cardiopulmonary complications in patients with NSCLC(P<0.05).Conclusions:The postoperative quality of life of NSCLC patients with COPD is significantly lower,and COPD will increase the risk of cardiopulmonary complications after NSCLC.