肺癌合并慢性阻塞性肺疾病诊治概况调查

目的 调查非呼吸科医师对肺癌合并慢性阻塞性肺疾病(COPD)患者的诊断治疗情况,以促进其规范诊治.方法 回顾性调查2009年1月至2010年12月在复旦大学附属中山医院非呼吸科(主要为胸外科)住院的肺癌合并COPD患者,收集其出入院资料,分析一般情况、肺功能检查结果以及治疗情况.结果 非呼吸科接诊的肺癌合并COPD患者共240例,有COPD诊断者5例(2.1％).稳定期患者210例,按照2010年GOLD指南规范用药的共计50例(23.8％);急性加重期患者30例,有选择支气管扩张剂的13例(43.3％),选择抗生素的26例(86.7％),选择应用糖皮质激素的1例(3.3％).结论 非呼吸科对肺癌合并COPD患者的COPD漏诊情况严重,治疗不充分、不规范.

A retrospective study of diagnosis and treatment of chronic obstructive pulmonary disease in patients with lung cancer

Objective To assess the diagnostic and therapeutic status of non-respiratory physicians managing chronic obstructive pulmonary disease(COPD)for patients with lung cancer at general hospitals to promote a standardized regimen.Methods Through a retrospective survey from January 2009 to December 2010 at our hospital,the data of clinical features,pulmonary function test results and information of therapy for lung cancer patients with COPD admitted at non-respiratory departments(mostly of thoracic surgery)were collected.Results A total of 240 lung cancer patients with COPD were admitted.Five patients were diagnosed as COPD with a diagnostic rate of 2.1％.And 210 cases of patients were stable.According to GOLD guidelines in 2010,only 50 cases were treated with adequate drugs(23.8％).Among another 30 patients with acute exacerbation,the following therapies were administrated:selective bronchodilator(n =13,43.3％),antibiotics(n=26,86.7％)and glucocorticoids(n=1,3.3％).Conclusion Underdiagnosis and inadequate treatment of COPD in lung cancer patients by non-respiratory physicians are too serious to be neglected.