在ⅢB和Ⅳ期肺癌综合治疗中减状性手术的临床价值  

Clinical value of the symptom-relieving operation in multimodality therapy of stage ⅢB and Ⅳ lung cancer

作　　者：谷力加[1] 吴一龙[1] 冯卫能[1] 翁毅敏[1] 程超[1] 钟文昭[1] 黄绍洪[1] 

机构地区：[1]中山医科大学第三附属医院胸心外科,肺癌研究中心,广州510630

出　　处：《中国肺癌杂志》2001年第6期407-409,共3页Chinese Journal of Lung Cancer

摘　　要：目的　探讨减状性手术在ⅢB和Ⅳ期肺癌综合治疗中提高生活质量和延长生存期的临床价值。方法　采用SPSS统计软件 ,对 2 9例ⅢB和Ⅳ期肺癌在综合治疗中减状性手术治疗前、后的疼痛发生率、生活质量、Karnofsky评分、麻醉评分、临床疗效及生存率进行统计学分析。治疗前、后差异的显著性检验用 χ2 检验和t检验。结果　 1 5例心包和胸腔积液患者 ,术后完全缓解率达 1 0 0 % ,1年生存率 6 6 .6 7% ,平均生存期(1 3 .81± 1 .6 1 )个月 ,中位生存期 1 6个月。 1 1例骨转移患者治疗后 1年生存率 2 0 .0 % ,平均生存期 (9.90±0 .99)个月 ,中位生存期 1 0个月。全组患者治疗后疼痛发生率由 89.7%下降到 3 4 .5 % (P <0 .0 0 1 ) ;Karnofsky评分由平均 (5 8.2 8± 2 .1 7)分提高到平均 (82 .41± 1 .5 4 )分 (P <0 .0 0 1 ) ;麻醉评分由 5 .1 7± 0 .5 3下降到 1 .45±0 .3 8(P <0 .0 0 1 )。结论　在ⅢB和Ⅳ期肺癌综合治疗中 ,针对转移病灶的减状性手术可有效地提高患者的生存质量、延长生存期及降低对止痛或麻醉药品的依赖性。Objective To explore the clinical value of the symptom relieving operation in multimodality therapy of stage ⅢB and Ⅳ lung cancer for rising quality of life and prolonging survival time. Methods The pain incidence rate, fraction of Karnofsky and anesthesia, clinical effect of treatment and survival rate of 29 cases were statistically analysed using SPSS software, in multimodality therapy of stage ⅢB and Ⅳ lung cancer, before and after symptom relieving operation. The difference between before and after operation was compared with χ 2 and t test. The survival rate was calculate with Kaplan Meier method. Results The complete remission rate for cases of malignant pleural effusion and pericardial effusion was 100% (15/15). The 1 year survival rate was 66.67%, mean survival time was 13.81±1.61 months, and median survival time was 16.00 months. The 1 year survival rate of cases with bone metastasis was 20.0%, mean survival time was 9.90± 0.99 months, median survival time was 10.00 months. After therapy, the pain incidence rate of all patients was decreased from 89.7% to 34.5% (P<0.001); Karnofsky score was increased from 58.28±2.17 to 82.41±1.54(P< 0.001 ); fraction of anesthesia was decreased from 5.17±0.53 to 1.45±0.38 (P<0.001). Conclusion The symptom relieving operation for metastasis lesion can rise the quality of life, prolong survival time, decrease dependence of anesthetic and analgesic drugs in multimodality therapy of stage ⅢB and Ⅳ lung cancer.

关 键 词：肺肿瘤 综合治疗 减状性手术 

分 类 号：R734.2[医药卫生—肿瘤]