Effect of Astragalus Injection Combined with Chemotherapy on Qual ity of Life in Patients with Advanced Non-small Cell Lung Cancer

Objective: To observe the effect of Astragalus injection (AI) combined with chemotherapy on quality of life (QOF) in patients with advanced non-small cell lung caner (NSCLC). Methods: Sixty NSCLC patients were randomly divided into the treated group (n=30,treated with AI combined with chemotherapy) and the control group (n=30, treated with chemotherapy alone). Chemotherapy of MVP protocol was applied to both groups. AI was supplemented to the treated group by intravenous dripping 60 ml per day. Treatment of 21-28 days consisted one treatment cycle, and 2-3 cycles were applied. WResults: The effective rate in the treated group was 40.0% and in the control group was 36.7%, the mean remission rate in them being 5.4 month s and 3.3 months, the median survival period 11 month and 7 month and the 1-year survival rate 46.75% and 30.0%, respectively, the difference of these indexes between the two groups were all significant (P<0 05). Moreover, the clinical improving rate and QOF elevation rate in the treated group was 80.4% and 43.3%, as compared with those in the control group (50.0% and 23.3% respectively), the different was also significant (P<0 01). Conclusion: AI combined with chemotherapy can significantly improve the QOF in NSCLC patients of advanced stage.

Quality of life of hospitalized patients after lung cancer operation and analysis of influencing factors

Objective:To explore the current status and influencing factors of quality of life in patients with lung cancer after surgery in a tertiary hospital in Hainan province.Methods:To investigate the influencing factors of quality of life of lung cancer patients after surgery in a tertiary hospital in Hainan province by cross‑sectional survey method.Results:The scores of insomnia,appetite loss,constipation and pain in 186 lung cancer patients after surgery in a tertiary hospital in Hainan Province were significantly higher than the reference value.Multiple linear regression analysis showed that older patients(>60 years)had lower scores in physical function domain(β=-0.193),and female patients had more appetite loss symptoms(β=0.245).Compared with other minority ethnic groups,Han ethnic group had lower scores in role function domain(β=0.179),more severe fatigue symptoms(β=-0.162),and higher general health level(β=0.166).Patients with employee medical insurance had lower scores of emotional function(β=0.194),cognitive function(β=0.281),the lowest score in social function(β=0.188),and severe pain in other parts(β=-0.227).Smokers had less cough symptoms(β=0.175)and more arm and shoulder pain symptoms(β=-0.21)than non‑smokers.Patients with secondhand smoke exposure had lower cognitive function scores(β=-0.158)and more obvious symptoms of oral ulcer(β=0.185).Patients who drank alcohol frequently(drinking frequency>1 time/day)had more severe cough symptoms(β=0.27).Patients with small number of children(0‑1)had milder cough symptoms(β=0.178).Patients who did not understand the disease had obvious symptoms of arm and shoulder pain(β=0.151).Patients with early pathological stage(stageⅠ‑Ⅱ)had more severe shortness of breath(β=-0.159)and pain(β=-0.181).The symptoms of appetite loss were more obvious in patients living in cities(β=0.192).The symptoms of peripheral neuropathy were more obvious(β=0.174).Patients who often consumed pickulated food had severe pain symptoms(β=-0.219),and pain in other parts was obvious(β=-0.149).Male patients had obvious alopecia symptoms(β=-0.306).Conclusion:Age,ethnicity,residence,type of medical insurance,number of children,pathological stage of lung cancer,smoking,second‑hand smoke exposure,alcohol consumption,and frequent consumption of pickled food were related to the quality of life of lung cancer patients in hospital after surgery.Medical staff and family members should pay attention to the emotional communication of patients during the treatment of lung cancer patients in hospital after surgery.Patients should avoid exposure to smoking,alcohol and second‑hand smoke,and reduce consumption of pickled food.

Clinical observation of docetaxel in treating advanced non-small cell lung cancer in the elderly patients

Objective:The aim of our study was to evaluate the clinical efficacy and side effects of docetaxel as single chemotherapy for elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty-two elderly patients with advanced NSCLC who were chemotherapy-naive were enrolled in this study. Docetaxel at the doses of 70 mg/m2 was administrated intravenously every 21 days as a cycle, each patient received 2-4 cycles. All patients were followed up until disease progressed or patients died. Results: Among 42 patients, 40 could be evaluated, 1 complete response (CR), 9 partial response (PR), 13 stable disease (SD), 17 progress disease (PD). The overall response rate (CR+PR) was 35% and disease control rate (CR+PR+SD) was 57.5%. The median time to progress (TTP) was 4.2 months, median survival time was 6.1 months and 1-year survival rate was 35.8%. The main toxicity was myelosuppression and decreasing platelet. Conclusion: Single agent docetaxel for elderly patients with advanced NSCLC is an efficient and well-tolerated chemotherapeutic approach with a low toxicity level.

Clinical Application and Research Progress of Accelerated Rehabilitation Surgery in Perioperative Period of Advanced Gastric Cancer in the Elderly

Enhanced recovery after surgery (ERAS) has been used in various surgical professions in recent years and is widely accepted by doctors. This concept not only helps patients speed up postoperative recovery, reduce the incidence of related complications and shorten hospital stays, but also has been proved to be effective and safe in the perioperative application of gastric cancer. This article reviews the clinical application and research progress of enhanced recovery after surgery in the perioperative period of advanced gastric cancer in the elderly.

Selecting the best strategy of treatment in newly diagnosed advanced-stage ovarian cancer patients

Although it is assumed that the combination of chemotherapy and radical surgery should be indicated in all newly diagnosed advanced-stage ovarian cancer patients, one of the main raised questions is how to select the best strategy of initial treatment in this group of patients, neoadjuvant chemotherapy followed by interval debulking surgery or primary debulking surgery followed by adjuvant chemotherapy. The selection criteria to offer one strategy over the other as well as a stepwise patient selection for initial treatment are described. Selecting the best strategy of treatment in newly diagnosed advanced stage ovarian cancer patients is a multifactorial and multidisciplinary decision. Several factors should be taken into consideration:(1) the disease factor, related to the extension and localization of the disease as well as tumor biology;(2) the patient factor, associated with patient age, poor performance status, and co-morbidities; and(3) institutional infrastructure factor, related to the lack of prolonged operative time, an appropriate surgical armamentarium, as well as well-equipped intensive care units with well-trained personnel.

Patient-Reported Outcomes of Surgery of Non-Small Cell Lung Cancer: Evaluation Based on the Questionnaires of Anti-Aging Quality of Life and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire

Background: Patient-reported outcomes of the quality of life (QOL) after an open thoracotomy have not been studied. To determine the physical and mental changes in surgical patients is very important for medical staffs. The surgical patient’s satisfaction and overall healthy changes were evaluated by the patient-self assessment questionnaires. Materials and Methods: From July 2007 to April 2008, 26 patients with non-small cell lung cancer (NSCLC) underwent surgical resection. The outcome of the QOL was evaluated by using two kinds of questionnaire surveys from the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the anti-aging QOL assessment (AA-QOL). The EORTC QLQ-C30 consisted of five domains (physical, role, cognitive, emotional, and social functionings) and global QOL. The AA-QOL contained 51 items;30 physical and 21 mental symptoms regarding the elderly and the aging population. The patients replied to the two questionnaires at two different times, i.e., at pre-surgery (baseline) and at post-surgery (2 weeks after the operation). The obtained data of these scores were averaged and compared between the two points of the pre-surgery and post-surgery. Results: Regarding the outcomes of the EORTC QLQ-C30, the physical and social functioning became significantly worse after the surgery. In contrast, the global QOL significantly became better after the surgery. For the symptom at post-surgery, three of which were “nausea and vomiting”, “pain”, and “appetite loss”, became significantly worse compared to those at pre-surgery. Regarding the outcomes of the AA-QOL, the physical symptoms (muscular pain/stiffness, palpitations, dyspnea, no feeling of good health, anorexia, and coughing and sputum) became significantly worse after the surgery. Regarding the mental symptoms, there were no significant differences. Conclusions: Regarding the outcomes based on the changes in the QOL after surgery, the physical symptoms became worse compared to the mental symptoms. To clarify the perioperative healthy changes of the QOL reported by patients with lung cancers is very important for multidisciplinary teamwork, which should play a role in providing the appropriate care and treatment and useful information for a preoperative patient’s decision making of receiving surgical treatment.

清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌患者的临床疗效及对其生活质量、血清癌胚抗原、神经元特异性烯醇化酶、细胞角质素片段抗原水平的影响

目的探讨清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌患者的临床疗效及对其生活质量、血清癌胚抗原(Carcinoembryonic antigen,CEA)、神经元特异性烯醇化酶(Neuron specific enolase,NSE)、细胞角质素片段抗原(Cytokeratin 19 fragment antigen21-1,CYRAF21-1)水平的影响。方法选取2019年7月—2020年10月期间在东南大学医学院附属南京同仁医院接受治疗的非小细胞肺癌患者80例,采用随机数字表法分为对照组和观察组,每组各40例。对照组采用DP化疗方案治疗,观察组在对照组基础上联合清肺化痰汤治疗,每个疗程为21 d,连续治疗4个疗程。观察比较两组患者临床疗效、不良反应情况,治疗前后痰热郁肺证证候积分(咳嗽,咳痰、咯痰黄稠,气喘或气急,喉中痰鸣,发热,口渴)、血清肿瘤标记物(CEA、NSE、CYRAF21-1)、生命质量量表(QOL-38)评分改善情况。结果治疗后观察组总缓解率62.5%(25/40)、临床获益率85.0%(34/40)均明显高于对照组总缓解率40.0%(16/40)、临床获益率65.0%(26/40),差异有统计学意义(P<0.05)。治疗后两组患者咳嗽、咳痰、咯痰黄稠、气喘或气急、喉中痰鸣、发热、口渴评分均较治疗前降低,差异有统计学意义(P<0.01);且观察组痰热郁肺证证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CEA、NSE及CYRAF21-1水平均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组血清CEA、NSE及CYRAF21-1水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者身体状况、情绪状况、功能状况、肺癌相关症状、社会/家庭状况评分均较治疗前明显降低,总体健康状况评分较治疗前明显升高,差异有统计学意义(P<0.01);且观察组QOL-38评分改善情况明显优于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌疗效显著,能够有效降低血清CEA、NSE及CYRAF21-1水平,缓解临床症状,减轻化疗药物不良反应,提高患者生活质量。

Bevacizumab in combination with pemetrexed and platinum for elderly patients with advanced non-squamous non-small-cell lung cancer:a retrospective analysis

Bevacizumab,an anti-VEGF monoclonal antibody,has significantly improved the clinical outcomes of patients with advanced non-squamous NSCLC(ns-NSCLC).However,the safety and efficacy of bevacizumab for elderly patients with advanced NSCLC require further investigation.Thus,59 patients were included in the present retrospective study,22 patients in the bevacizumab plus pemetrexed and platinum(B+PP)group,and 37 patients in the pemetrexed and platinum(PP)group.For the entire cohort of patients,the median OS was 33.3 months,and the 1-year and 2-year overall survival rates were 88.5%and 67.8%,respectively.The median OS and 1-year and 2-year OS rates were 20.5 months,70.3%and 0%,respectively,in the B+PP group and 33.4 months,97.0%and 89.4%,respectively,in the PP group(P<0.001).The incidence of grade≥3 adverse events was higher in the B+PP group than in the PP group(27.3%vs.10.8%,respectively;P=0.204).Univariate and multivariate analyses suggested that the receipt of≥5 cycles of first-line chemotherapy was an independent favorable prognostic factor for OS,whereas the addition of bevacizumab was an unfavorable prognostic factor.With increased toxicities,the addition of bevacizumab to PP does not improve the overall survival of elderly patients with advanced ns-NSCLC.

An Elderly Patient with Advanced Lung Cancer Achieved Long-Term Survival Using Chinese Medicine:An Alternative Treatment Strategy for Cancer Patients Aged 80 or Older without A Tissue Confirmed Diagnosis

Lung cancer is the leading cause of cancerrelated mortality in China.（1＇2） Meanwhile, the average life expectancy in the aging population has increased from 46 years in 1950 to 75 years in 2010.

ERAS护理模式联合病友互助模式在肺癌根治术后老年患者康复中的应用效果

目的探讨ERAS护理模式联合病友互助模式在肺癌根治术老年患者中的康复效果。方法选取河南省胸科医院,郑州大学附属胸科医院2021年10月至2022年10月收治的78例肺癌根治术患者,按随机数字表法分为对照组和观察组,各39例。对照组采用常规护理,观察组采用ERAS护理联合病友互助模式。比较两组干预后的围手术期指标、疼痛评分、肺功能指标、希望水平及病耻感评分。结果观察组围手术期指标改善优于对照组;观察组术后12 h、后24 h、后72 h疼痛评分低于对照组;观察组二氧化碳分压(PaCO_(2))、血氧分压(PaO_(2))、血氧饱和度(SpO_(2))水平高于对照组;观察组希望水平评分高于对照组,病耻感评分低于对照组,差异有统计学意义(P<0.05)。结论ERAS护理模式联合病友互助模式有效改善老年肺癌根治术患者围手术期指标和肺功能,降低疼痛程度,提高希望水平,降低病耻感。

基于肺超声指导个体化肺保护通气对老年患者术后膈肌功能的影响

目的探讨基于肺超声指导个体化肺保护性通气对老年患者术后膈肌功能的影响。方法选取2023年1—12月在泰州市人民医院行腹腔镜结肠癌根治术老年患者80例作为研究对象,采用随机数字表法将其分为传统肺保护性通气组(T-LP组)和基于肺超声个体化肺保护性通气组(U-LP组),各40例。T-LP组采用低潮气量(VT)、持续固定呼气末正压(PEEP)和固定手法膨肺(RM)压力实施传统模式肺保护性通气策略;U-LP组在T-LP组基础上基于肺超声滴定个体化PEEP和RM压力来实施个体化肺保护性通气策略。2组分别于全身麻醉诱导前、拔管后15 min、拔管后30 min和准备离开麻醉恢复室(PACU)时记录平静呼吸(QB)和深呼吸(DB)期间膈肌偏移(DE)[平静呼吸膈肌偏移(DEQ)、深呼吸膈肌偏移(DED)]、膈肌厚度(DT)[平静吸气膈肌厚度(DTQi)、平静呼气膈肌厚度(DTQe)、深吸气膈肌厚度(DTDi)、深呼气膈肌厚度(DTDe)]及膈肌增厚分数(DTF)[平静呼吸膈肌增厚分数(DTFQ)、深呼吸膈肌增厚分数(DTFD)]等膈肌超声监测指标,停用肌肉松弛药至4个成串刺激(TOFr)90%时间,拔管至Aldrete评分9分时间,以及需舒更葡糖钠拮抗肌松残余的病例数等。结果与全身麻醉诱导前比较,离开PACU时T-LP组DEQ、DED、DTQi、DTQe、DTFQ、DTDi、DTFD等膈肌超声指标均明显减少、变薄或降低(P<0.05),U-LP组DTDi指标明显变薄(P<0.05);与T-LP组比较,U-LP组离开PACU时DEQ明显增加(P<0.05),拔管后15、30 min和离开PACU时DED、DTDi、DTFD均明显增加或增厚(P<0.05),拔管后30 min和离开PACU时DTQi、DTQe、DTDe均明显增厚(P<0.05);拔管至Aldrete评分≥9分时间明显缩短(P<0.05)。结论U-LP对老年腹腔镜结肠癌根治术患者术后膈肌功能影响轻微,更利于术后膈肌功能恢复,缩短PACU内滞留时间。

四逆散联合桃红四物汤加减治疗老年早期肺癌胸腔镜术后急性胸痛患者的临床疗效及对其生活质量的影响

目的探讨四逆散联合桃红四物汤加减治疗老年早期肺癌胸腔镜术后急性胸痛患者的临床疗效及对其生活质量的影响。方法选取2019年1月-2020年6月期间在保定市第二中心医院接受治疗的86例非小细胞肺癌患者,采用随机数字表法分为对照组和观察组,每组各43例。对照组患者胸腔镜术后给予尼美舒利胶囊口服治疗,观察组患者胸腔镜术后给予四逆散合桃红四物汤加减方治疗。治疗2周后,观察比较两组患者临床疗效、不良反应情况,治疗前后疼痛状况评分[数字分级评分法评分(Numeric rating scale,NRS)、疼痛视觉模拟评分法评分(Visual analogue scale,VAS)]、咳嗽评分[咳嗽积分和咳嗽视觉模拟评分法(Visual analogue scale,VAS)]、EORTC QLQ-C30(version 3)生活质量量表评分。结果治疗后观察组总有效率93.02%(40/43)明显高于对照组74.42%(32/43),差异有统计学意义(P<0.05)。治疗后两组患者疼痛状况NRS、VAS评分均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组疼痛状况NRS、VAS评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者咳嗽状况咳嗽积分、咳嗽VAS评分均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组咳嗽状况咳嗽积分、咳嗽VAS评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者角色功能、躯体功能、认知功能、情绪功能、社会功能及总体健康状况评分均较治疗前升高,差异有统计学意义(P<0.01),两组患者恶心呕吐、疼痛评分均较治疗前降低,差异有统计学意义(P<0.01);且观察组角色功能、躯体功能、认知功能、情绪功能、社会功能及总体健康状况评分均明显高于对照组,观察组恶心呕吐、疼痛评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者肾功能、肝功能、血常规、心电图、尿常规、便常规等安全性指标均未出现明显异常,也未发生与药物使用相关的严重不良反应。结论四逆散合桃红四物汤加减方能够有效缓解早期肺癌患者胸腔镜术后急性疼痛程度和咳嗽程度,缩短疼痛治疗时间,减少西医止痛药物使用剂量,改善患者生活质量,安全且有效。

肺癌合并慢性阻塞性肺疾病手术患者预康复的研究进展

预康复通过多种术前优化的干预措施可减少患者的围术期应激反应,加速患者术后康复。通过文献回顾对肺癌合并慢性阻塞性肺疾病患者预康复措施、预康复应用于临床护理实践中的障碍与促进因素进行综述,旨在为肺癌并存慢性阻塞性肺疾病患者实施针对性干预,促进术后快速康复、减少术后肺部并发症提供参考。

自尊在晚期肺癌化疗病人领悟社会支持和经验性回避间的中介效应

目的:探讨自尊在晚期肺癌化疗病人领悟社会支持和经验性回避间的中介效应。方法:采用便利抽样法,选取2023年6月—8月湖南省某肿瘤医院的392例晚期肺癌化疗病人,采用一般资料调查表、领悟社会支持量表、自尊量表和接纳与行动问卷第二版对病人进行调查。结果:晚期肺癌化疗病人经验性回避得分为(26.28±8.53)分,与领悟社会支持(r=-0.524,P<0.001)、自尊(r=-0.505,P<0.001)呈负相关;自尊在领悟社会支持与经验性回避间起部分中介作用[间接效应系数为-0.136,95%CI(-0.362,-0.182)],中介效应占比22.44%。结论:领悟社会支持可负向预测肺癌化疗病人经验性回避,自尊在其中起部分中介作用。建议医务工作者可以通过增强病人的领悟社会支持状况,提高病人的自尊水平,以减少晚期肺癌病人的经验性回避程度。

程序化急救联合快速通道手术临床护理路径模式干预对晚期肺癌咯血患者呼吸功能及生活质量的影响

目的探讨程序化急救联合快速通道手术临床护理路径(FTS-CNP)模式干预对晚期肺癌(LC)咯血患者呼吸功能及生活质量的影响。方法将82例晚期LC咯血患者按干预方法的不同分为观察组40例和对照组42例,观察组采取程序化急救联合FTS-CNP模式干预,对照组采取常规干预。比较两组患者的呼吸功能[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及FEV_(1)/FVC]、生活质量[癌症患者生命质量测定量表(FACT-G)]、并发症发生情况及满意度。结果干预4周后,两组患者FEV_(1)、FVC、FEV_(1)/FVC均较干预前升高,且观察组患者FEV_(1)、FVC、FEV_(1)/FVC均高于对照组,差异均有统计学意义(P﹤0.05)。干预4周后,两组患者FACT-G量表评分均较干预前降低,且观察组患者FACT-G量表评分低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者并发症总发生率低于对照组,满意情况优于对照组,差异均有统计学意义(P﹤0.05)。结论程序化急救联合FTS-CNP模式干预可有效改善晚期LC咯血患者呼吸功能,减少并发症发生,且有助于提高患者的生活质量及干预满意度。

Longer Overall Survival in A Patient with Advanced Non-small Cell Lung Cancer Treated with Chinese Medicine and Chemotherapy

Non-small cell lung cancer （NSCLC） is the leading cause of cancer death in the industrialized world. Despite significant progress in early stage of the disease, the overall survival rates for advanced disease remain low. Herein we present a case of NSCLC who was treated with Chinese medicine and chemotherapy with a longer overall survival.

支气管动脉化疗栓塞联合康艾对中晚期肺癌转化治疗的临床疗效

目的探讨通过支气管动脉灌注化疗栓塞联合康艾注射液对初始不可切除的Ⅲ期中央型非小细胞肺癌(non-small cell lung cancer,NSCLC)患者转化为根治性手术切除的临床疗效。方法选取中央型NSCLC患者36例,经支气管镜活检或经皮肺穿刺活检明确病理类型;通过颈胸部增强CT、头颅MRI、骨扫描和腹部CT检查进行临床评估及分期,确认为不可切除的Ⅲ期中央型NSCLC。36例患者均采用支气管动脉灌注化疗栓塞联合康艾注射液治疗,治疗两周期后评估能否手术切除。比较手术切除患者和不能手术切除患者的生存率和中位生存期。结果36例初始不可切除的Ⅲ期中央型NSCLC患者经过支气管动脉灌注化疗栓塞联合康艾注射液治疗后,其中可行根治性手术切除23例患者,术后给予辅助静脉化疗,不能手术切除13例继续给予静脉化疗或放疗。23例手术切除患者的中位生存期为31.2个月,1,2,3年生存率分别为78.2%、69.5%和56.5%。13例不能切除患者的中位生存期为15.6月,1,2,3年生存率分别为61.5%、38.5%和23.1%。结论通过支气管动脉化疗栓塞联合康艾注射液对初始不可切除的Ⅲ期中央型NSCLC患者转化为根治性手术切除取得了良好的临床疗效,值得大力推广。

胸腔镜肺癌手术治疗老年非小细胞肺癌的临床效果

目的探讨针对老年非小细胞肺癌患者在治疗中采用胸腔镜肺癌手术的应用价值,观察患者预后情况,评价治疗效果。方法随机选取2020年8月—2022年7月在单县中心医院收治的110例老年非小细胞肺癌患者为研究对象,按照随机数表法分为两组,每组55例。对照组在治疗中实施传统开胸手术,研究组在治疗中采取胸腔镜肺癌手术,对比手术及术后恢复指标、肺功能指标、炎性因子水平、白细胞计数、并发症发生率、T淋巴细胞亚群指标。结果研究组手术时间、术中出血量、胸腔引流量、引流管留置时间、术后止痛药物使用量以及住院时间均少于对照组,差异有统计学意义(t=12.448、16.108、13.453、10.792、30.709、9.500,P<0.05)。两组淋巴结清扫个数比较,差异无统计学意义(t=0.145,P>0.05);治疗后,研究组FEV1、FVC、MVV均高于对照组,差异有统计学意义(t=10.883、10.267、11.167,P<0.05);治疗后,研究组IL-6、CRP、TNF-α、WBC均低于对照组,差异有统计学意义(t=17.044、15.378、11.018、11.693,P<0.05)。研究组并发症发生率为3.64%低于对照组,差异有统计学意义(χ^(2)=5.986,P<0.05);治疗后,研究组CD4^(+)、CD4^(+)/CD8^(+)均高于对照组,CD8^(+)低于对照组,差异有统计学意义(t=12.610、11.461、11.891,P<0.05)。结论在老年非小细胞肺癌患者的治疗中采取胸腔镜肺癌手术治疗可缩短手术及术后恢复时间,降低并发症发生率,改善肺功能与免疫功能。

第三腰椎旁肌肉指数对晚期非小细胞肺癌营养不良风险的预测价值

目的分析第三腰椎旁肌肉指数(L_(3)-SMI)与晚期非小细胞肺癌(NSCLC)营养状态之间的关系,以进一步明确L_(3)-SMI是否可以作为评估NSCLC营养不良的有效预测参数。方法选择2016年1月至2020年12月间于阜宁县人民医院行放、化疗的100例Ⅲ~Ⅳ期NSCLC为研究对象,并根据患者主观整体评估(PG-SGA)将所有患者分为重度营养不良组与非重度营养不良组。采用单、多因素Logistic回归分析确定各评价参数与重度营养不良的相关性,并通过受试者操作特征(ROC)曲线比较不同评价参数对NSCLC重度营养不良的预测价值。结果PG-SGA量表发现严重营养不良在进展期或晚期NSCLC中的发生率高达48.0%。与非重度营养不良组相比,重度营养不良组年龄更大[(65.4±10.0)岁比(61.2±6.9)岁,t=2.482,P=0.015)],控制营养状态评分更高[3(1,5)分比2(1,4)分,t=2.238,P=0.027],而体质指数[(21.1±3.2)kg/m^(2)比(25.2±3.8)kg/m^(2),t=-5.840,P<0.001)]、血清白蛋白水平[(33.8±4.7)g/L比(36.4±3.9)g/L,t=-2.970,P=0.004)]、预后营养指数[(41.5±5.3)比(44.7±5.0),t=-3.122,P=0.002)]及L_(3)-SMI更低[(36.0±8.9)比(53.1±12.3),t=-8.103,P<0.001)]。多因素Logistic回归分析证实血清低白蛋白水平(OR=0.791,95%CI=0.678~0.922,P=0.003)和低L_(3)-SMI(OR=0.826,95%CI=0.765~0.892,P<0.001)是严重营养不良的危险因素。ROC曲线展示L_(3)-SMI对NSCLC的营养状态具有良好预测效能(AUC值:0.888,95%CI=0.822~0.955),优于其他血液学参数。结论L_(3)-SMI与PG-SGA具有高度一致性,是一项筛查晚期NSCLC营养不良风险的有效指标。

肺癌手术后在院患者生命质量调查及影响因素分析

目的:探究海南省某三甲医院肺癌手术后在院患者生命质量现状及其影响因素。方法:采用横断面调查研究方法,对海南省某三甲医院肺癌手术后在院患者进行调查,探究肺癌手术后在院患者生命质量的影响因素。结果:海南省某三甲医院186名肺癌手术后在院患者的失眠症状、食欲丧失症状、便秘症状疼痛症状领域得分明显高于参考值。多重线性回归分析显示,年龄大(>60岁)的患者躯体功能领域得分低(β=-0.193),女性患者食欲丧失症状明显(β=0.245);汉族较其他少数民族角色功能领域得分低(β=0.179),汉族(β=-0.162)疲倦症状重,少数民族总体健康水平高(β=0.166);职工医保的患者情绪功能得分较低(β=0.194),认知功能得分较低(β=0.281),社会功能领域得分最低(β=0.188),其他部位痛的症状重(β=-0.227);吸烟患者咳嗽症状比不吸烟患者轻(β=0.175),手臂肩膀痛症状重(β=-0.21);有二手烟接触的患者认知功能得分较低(β=-0.158),口腔溃疡的症状明显(β=0.185);经常饮酒的患者(饮酒频率>1次/天)咳嗽症状重(β=0.27);子女数量少(0~1个)的患者咳嗽症状轻(β=0.178);不了解病情的患者手臂肩膀痛的症状明显(β=0.151);肺癌病理分期较早的患者(Ⅰ~Ⅱ期)气促症状重(β=-0.159),疼痛症状重(β=-0.181);居住在城市的患者食欲丧失症状明显(β=0.192);外周神经病变的症状更为明显(β=0.174);经常食用腌制食物的患者疼痛症状重(β=-0.219),其他部位痛(β=-0.149)症状明显;男性患者脱发症状明显(β=-0.306)。结论:年龄、民族、居住地归属、医保类型、子女数量、肺癌病理分期、吸烟、二手烟接触、饮酒、经常食用腌制食物等因素与肺癌手术后在院患者生命质量相关;在肺癌手术后在院患者的治疗过程中,医护人员及病人家属应注意患者的情绪沟通;患者应避免吸烟、饮酒与二手烟的接触,减少食用腌制食物。