老年综合评估下非小细胞肺癌发病危险因素分析及术后管理效果研究  

Analysis of risk factors for non-small cell lung cancer and postoperative management outcomes using comprehensive geriatric assessment

作　　者：陆红艳 顾一航 沈卫东 张丽萍 糜烨东 LU Hongyan;GU Yihang;SHEN Weidong;ZHANG Liping;MI Yedong(Department of Thoracic Surgery,Jiangyin People′s Hospital,Jiangyin Clinical College,Xuzhou Medical University,Jiangyin,Jiangsu 214400,China;Department of Geriatrics,Jiangyin People′s Hospital,Jiangyin Clinical College,Xuzhou Medical University;Department of Gastroenterology,Jiangyin Fourth People′s Hospital,Jiangyin,Jiangsu 214421)

机构地区：[1]徐州医科大学江阴临床学院,江阴市人民医院胸外科,江苏江阴214400 [2]徐州医科大学江阴临床学院,江阴市人民医院老年医学科 [3]江阴市第四人民医院消化内科,江苏江阴214421

出　　处：《徐州医科大学学报》2024年第12期931-936,共6页Journal of Xuzhou Medical University

基　　金：江阴市卫生健康委员会科研项目(M202316);江苏省老年健康科研项目(LSD2022007,LD2022005)。

摘　　要：目的探讨老年综合评估(CGA)在老年非小细胞肺癌(NSCLC)患者中的应用效果,识别老年NSCLC患者发病危险因素,并评估基于CGA的个体化术后管理对患者康复的影响。方法采用回顾性和前瞻性相结合的研究方法。回顾性研究部分纳入江阴市人民医院收治的300例老年患者,分为肺癌组(n=150)和对照组(n=150),通过单因素和多因素分析识别与NSCLC相关的独立危险因素。前瞻性研究部分纳入80例老年NSCLC患者,随机分为研究组和对照组,每组各40例。研究组接受基于CGA的个体化术后管理,对照组接受常规术后管理。通过随访评估2组患者的术后恢复情况,包括生活质量、功能状态及并发症发生率等。结果吸烟史、饮酒史、衰弱、营养不良、焦虑和抑郁是老年NSCLC患者的独立危险因素,而高密度脂蛋白是保护因素。基于CGA的个体化管理显著改善了老年NSCLC患者的术后恢复,包括提高生活质量、降低并发症发生率和缩短住院时间(P<0.05)。结论CGA在老年NSCLC患者管理中能够识别更多相关的危险因素并优化个体化治疗,建议在临床实践中广泛应用以改善患者预后。Objective To explore the application of comprehensive geriatric assessment(CGA)in elderly patients with non-small cell lung cancer(NSCLC),identify aging-related risk factors influencing the prognosis of these NSCLC patients and evaluate the impact of CGA-based individualized postoperative management on patient recovery.Methods A combined retrospective and prospective research method was adopted.The retrospective study included 300 elderly patients treated in Jiangyin People′s Hospital,and the patients were divided into a lung cancer group(n=150)and a control group(n=150).The independent risk factors associated with NSCLC were identified by univariate and multivariate analyses.The prospective study included 80 elderly NSCLC patients and these patients were randomly divided into a study group and a control group(n=40).The study group received CGA-based individualized postoperative management,while the control group underwent standard postoperative management.Follow-ups were conducted to evaluate postoperative recovery,including quality of life,functional status,and incidence of complications.Results Smoking history,alcohol consumption,frailty,malnutrition,anxiety,and depression were identified as independent risk factors for NSCLC in elderly patients,whereas high-density lipoprotein showed protective effect.CGAbased individualized management significantly improved postoperative recovery in elderly NSCLC patients,including enhanced quality of life,reduced complication rates,and shortened the length of hospitalization stays(P<0.05).Conclusions CGA is crucial in managing elderly NSCLC patients which can identify a broader range of aging-related risk factors and optimize individualized treatment.Its widespread application in clinical practice is recommended to improve patient prognosis.

关 键 词：老年综合评估 非小细胞肺癌 危险因素 术后管理 个体化治疗 

分 类 号：R734.2[医药卫生—肿瘤]