非小细胞肺癌患者肺叶切除术后持续干咳的影响因素  

Influencing factors for persistent dry cough in patients with non-small cell lung cancer after pulmonary lobectomy

作　　者：马志飞[1] 张爱平[1] 黄福华[1] 郑琳[1] MA Zhifei;ZHANG Aiping;HUANG Fuhua(Department of Cardiothoracic Surgery,Nanjing First Hospital,Nanjing Medical University,Nanjing 210000,CHINA)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)心胸外科,江苏210000

出　　处：《江苏医药》2022年第9期887-890,共4页Jiangsu Medical Journal

基　　金：江苏省重点研发专项基金(BE2017610)。

摘　　要：目的 分析非小细胞肺癌(NSCLC)患者肺叶切除术后持续干咳的影响因素。方法回顾性分析行肺叶切除术的420例NSCLC患者的临床资料,采用多因素logistic回归分析术后持续干咳的影响因素。术前、术后第20天和6个月使用中文版莱斯特咳嗽问卷(LCQ-MC)评分评价患者干咳情况。将术后持续干咳的患者随机均分为两组,A组予镇咳药口服1周,B组不予镇咳药,比较两组干咳停止的时间。结果 420例患者中,204例(48.6%)术后出现持续干咳。多因素logistic回归分析结果显示,右侧肺癌手术时清扫第2R组和/或第4R组淋巴结、行下肺韧带松解、困难气管插管、术前有急性咳嗽和慢性阻塞性肺疾病(COPD)病史是患者术后持续干咳的独立危险因素(P<0.05)。与术前相比,患者术后第20天的LCQ-MC评分降低(P<0.05),术后6个月恢复(P>0.05)。A组与B组干咳停止的时间无统计学差异(P>0.05)。结论 右侧肺癌手术时清扫第2R组和/或第4R组淋巴结、行下肺韧带松解、困难气管插管、术前有急性咳嗽和COPD病史是NSCLC患者肺叶切除术后持续干咳的独立危险因素。镇咳药对术后持续干咳的恢复无明显影响。Objective To analyze the influencing factors for persistent dry cough in the patients with non-small cell lung cancer(NSCLC) after pulmonary lobectomy.Methods The clinical data of 420 patients with NSCLC underwent pulmonary lobectomy were retrospectively analyzed.The influencing factors for postoperative persistent dry cough were analyzed by multivariate logistic regression.The Mandarin Chinese version of the Leicester Cough Questionnaire(LCQ-MC) was used to evaluate the cough of patients before operation and on the 20day and in the 6month after operation.The patients with persistent dry cough after operation were randomly and equally divided into two groups.Group A was given antitussive drugs orally for a week, and group B was not given antitussive drugs.The time of cough disappearance was compared between the two groups.ResultsOf 420 patients, 204 cases(48.6%) developed persistent dry cough after operation.Multivariate logistic regression analysis showed that dissection of the lymph nodes of group 2 R and/or group 4 R during right lung cancer surgery, release of lower pulmonary ligament, difficult airway intubation, preoperative history of acute cough and chronic obstructive pulmonary disease(COPD) were the independent risk factors for postoperative persistent dry cough(P<0.05).Compared with before operation, the LCQ-MC score was decreased on the 20day after operation(P<0.05),which recovered in the 6month after operation(P>0.05).There was no significant difference in the time of cough disappearance between group A and group B(P>0.05).Conclusion Dissection of the lymph nodes of group 2 R and/or group 4 R during right lung cancer surgery, release of the lower pulmonary ligament, difficult airway intubation, preoperative acute cough and COPD history are the independent risk factors for persistent dry cough in the patients with NSCLC after pulmonary lobectomy.Antitussive drugs have no significant effect on the recovery of postoperative persistent dry cough.

关 键 词：非小细胞肺癌 肺叶切除术 干咳 

分 类 号：R734[医药卫生—肿瘤]