發(fā)布時(shí)間：2018-02-20 21:53

  本文關(guān)鍵詞： 慢性阻塞性肺疾病 原發(fā)性支氣管肺癌 臨床特征　出處：《中國肺癌雜志》2017年08期 　論文類型：期刊論文

【摘要】：背景與目的探討慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并原發(fā)性支氣管肺癌的臨床特征,以便臨床早期診斷COPD合并原發(fā)性支氣管肺癌患者。方法回顧性分析我院2013年1月-2016年12月118例COPD合并原發(fā)性支氣管肺癌患者的臨床資料,包括年齡、性別、吸煙史、吸煙指數(shù)、臨床癥狀及體征、病理類型、分期、轉(zhuǎn)移部位及肺功能指標(biāo),選擇同時(shí)期的120例單純性COPD患者作為對(duì)照。結(jié)果 COPD合并肺癌組患者吸煙率(55.1%)及吸煙指數(shù)≥400支/年患者比例(90.8%)均高于單純COPD組患者(20.8%,48.0%),組間差異有統(tǒng)計(jì)學(xué)意義(P0.01);COPD合并肺癌組患者常見癥狀如咳嗽、咳痰、發(fā)熱、乏力、呼吸困難發(fā)生率與單純COPD組患者相比無統(tǒng)計(jì)學(xué)差異(P0.05),而咯血、消瘦、胸痛、聲音嘶啞、胸腔積液、肺不張發(fā)生率均顯著高于單純COPD組患者,差異有統(tǒng)計(jì)學(xué)意義(P0.01);COPD合并肺癌組患者首次診斷時(shí)63.6%為晚期或局部晚期,遠(yuǎn)處轉(zhuǎn)移以胸膜轉(zhuǎn)移和骨轉(zhuǎn)移多見;兩組患者之間第一秒用力呼氣容積(forced expiratory volume in one second,FEV_1)與用力肺活量(forced vital capacity,FVC)比值(FEV_1/FVC)、FEV_1占預(yù)計(jì)值的百分比(FEV_1%pre)、肺總量(total lung capacity,TLC)、殘氣容積(residual volume,RV)與TLC的比值(RV/TLC)無明顯差異(P0.05),但COPD合并肺癌組患者的一氧化碳彌散量(diffusing capacity of carbon monoxide,DLCO)較單純COPD組患者降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);COPD合并肺癌組患者病理類型以鱗癌最多見(51.7%),其中男性患者以鱗癌(60.7%)為主,而女性患者以腺癌(69.0%)為主。結(jié)論 COPD合并原發(fā)性支氣管肺癌好發(fā)于男性吸煙患者,鱗癌發(fā)生率高,早期臨床表現(xiàn)缺乏特異性,首次診斷時(shí)多為晚期或局部晚期,定期對(duì)COPD患者行胸部CT檢查可以盡早發(fā)現(xiàn)肺癌。
[Abstract]:Background & objective to investigate the clinical features of chronic obstructive pulmonary disease (pulmonary) associated with primary bronchial lung cancer. Methods the clinical data of 118 patients with COPD complicated with primary bronchogenic carcinoma from January 2013 to December 2016 were analyzed retrospectively, including age, sex, smoking history and smoking index. Clinical symptoms and signs, pathological types, stages, metastatic sites and pulmonary function, Results the smoking rate and smoking index of patients with COPD combined with lung cancer were 55.1) and the proportion of smoking index 鈮，

本文編號(hào)：1520127