Effect of bronchodilator therapy on the function of external respiration and lung parenchyma in surgical treatment of patients with non-small cell lung cancer combined with chronic obstructive pulmonary disease

Q4 Medicine
C.Ю. Добнер, С. В. Федосенко, А.Ю. Добродеев, Н.Д. Яровой, Е.Н. Самцов, А.В. Дубаков, Е.А. Старовойтова, О.А. Денисова, Н.А. Кириллова, S. Dobner, S. Fedosenko, А.yu. dobrodeev, N.d. yarovoy, Е.N. Samtsov, А.V. dubakov, Е.А. Starovoitova, О.А. denisova, N. Kirillova
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引用次数: 0

Abstract

The purpose of the study was to compare the efficacy of regular prolonged inhalation therapy with tiotropium bromide delivered via the Respimat inhaler and short-acting bronchodilator (SAB) therapy with ipratropium bromide/fenoterol in the perioperative period in patients with non-small cell lung cancer (NSCLC) combined with chronic obstructive pulmonary disease (copd).Material and Methods. The study included 66 patients with Nsclc and copd. The patients received tiotropium bromide, 5 mcg/day (TB group) or a combination of ipratropium bromide/fenoterol 20/50 mcg/dose, 2 doses 4 times a day (SAB group) for 6 weeks before and 6 weeks after surgery. The control group consisted of patients who did not receive bronchodilators before surgery, but they received a combination of ipratropium bromide/fenoterol in the postoperative period. All patients underwent tests of pulmonary function (spirometry, body plethysmography), measurement of lung parenchyma density and emphysematous lung areas (high-resolution computed tomography).Results. After preoperative preparation with use of tB or saB, there was a significant improvement in FEV1, FVC, VC, RV, ITGV, and. RV/TLC ratio relative to baseline. In the tB and sad groups, a significant reduction in the severity of total respiratory resistance (Rtot) compared to that in the control group was observed. According to the assessment of lung density and the volume of emphysematous areas on expiration, the results in the TB group were significantly better than those in the sad and control groups. six weeks after surgery, all patients showed a significant decrease in post-FeV1, post-FVC, and post-VC relative to the preoperative values. Bronchodilator therapy resulted in the reduction in Rtot in all groups; however, better results were achieved in the TB group (86 %) compared to sad group (93 %, p=0.03) and control (101.5 %, p=0.02). After surgical treatment, a decrease in the volume of emphysematous areas on inspiration was observed: the parameters were better in the TB group than in the sad and control groups (220 cm3 versus 1025 cm3 and 1002 cm3, p<0.001 and p=0.002, respectively).Conclusion. In patients with Nsclc and copd, longterm inhaled bronchodilator therapy can significantly improve respiratory function. more beneficial results are achieved after using long-acting drugs (tiotropium bromide).
非小细胞肺癌合并慢性阻塞性肺病患者手术治疗中支气管扩张剂治疗对体外呼吸功能和肺实质的影响
该研究的目的是比较非小细胞肺癌(NSCLC)合并慢性阻塞性肺病(copd)患者围手术期使用噻托溴铵吸入器(Respimat inhaler)和异丙托溴铵/非诺特罗(ipratropium bromide/fenoterol)短效支气管扩张剂(SAB)常规长效吸入疗法的疗效。研究对象包括 66 名非小细胞肺癌合并慢性阻塞性肺疾病患者。患者在手术前 6 周和手术后 6 周接受噻托溴铵 5 毫克/天(TB 组)或异丙托溴铵/非诺特罗 20/50 毫克/天的联合用药,每天 4 次,每次 2 剂(SAB 组)。对照组包括术前未服用支气管扩张剂的患者,但他们在术后服用了异丙托溴铵/非诺特罗复合制剂。所有患者都接受了肺功能测试(肺活量、体温测定)、肺实质密度和肺气肿面积测量(高分辨率计算机断层扫描)。使用 tB 或 saB 进行术前准备后,FEV1、FVC、VC、RV、ITGV 和 RV/TLC 比值相对于基础值有显著改善。RV/TLC比值相对于基线有明显改善。与对照组相比,tB 组和 sad 组的总呼吸阻力(Rtot)明显降低。根据肺密度和呼气时肺气肿面积的评估,肺结核组的结果明显优于悲伤组和对照组。术后六周,所有患者的术后FeV1、术后FVC和术后VC均较术前值明显下降。支气管扩张剂治疗使所有组的 Rtot 均有所下降;但肺结核组(86%)的效果优于悲伤组(93%,P=0.03)和对照组(101.5%,P=0.02)。手术治疗后,可观察到吸气时气肿区域的体积缩小:肺结核组的参数优于悲伤组和对照组(分别为 220 cm3 对 1025 cm3 和 1002 cm3,p<0.001 和 p=0.002)。对于 Nsclc 和 copd 患者,长期吸入支气管扩张剂治疗可显著改善呼吸功能。
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来源期刊
Siberian journal of oncology
Siberian journal of oncology Medicine-Oncology
CiteScore
0.40
自引率
0.00%
发文量
117
审稿时长
8 weeks
期刊介绍: The main objectives of the journal are: -to promote the establishment of Russia’s leading worldwide positions in the field of experimental and clinical oncology- to create the international discussion platform intended to cover all aspects of basic and clinical cancer research, including carcinogenesis, molecular biology, epidemiology, cancer prevention, diagnosis and multimodality treatment (surgery, chemotherapy, radiation therapy, hormone therapy), anesthetic management, medical and social rehabilitation, palliative care as well as the improvement of life quality of cancer patients- to encourage promising young scientists to be actively involved in cancer research programs- to provide a platform for researches and doctors all over the world to promote, share, and discuss various new issues and developments in cancer related problems. (to create a communication platform for the expansion of cooperation between Russian and foreign professional associations).- to provide the information about the latest worldwide achievements in different fields of oncology The most important tasks of the journal are: -to encourage scientists to publish their research results- to offer a forum for active discussion on topics of major interest - to invite the most prominent Russian and foreign authors to share their latest research findings with cancer research community- to promote the exchange of research information, clinical experience, current trends and the recent developments in the field of oncology as well as to review interesting cases encountered by colleagues all over the world- to expand the editorial board and reviewers with the involvement of well-known Russian and foreign experts- to provide open access to full text articles- to include the journal into the international database- to increase the journal’s impact factor- to promote the journal to the International and Russian markets
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