76例支气管肺癌临床分析和健康教育对策

目的通过对Ⅳ期支气管肺癌的吸烟、转移和生存期等情况进行分析,探讨一条以政府为主导,以社区干预为核心,以健康教育为抓手的健康教育对策,提高人们的健康水平。方法采用回顾性方法,对均已死亡的76例非小细胞未手术的Ⅳ期支气管肺癌的吸烟史、生存期、远道转移、死亡原因及相互关系进行分析。结果吸烟与肺癌关系的知晓率为93.4%,二手烟接触史100%;腺癌为最常见的病理类型。骨转移为最早(3月)、转移率最高(55.3%)并以多处骨转移存在,中位生存期6月;脑转移为第二好发的脏器(36.8%),中位生存期4月。治疗组的中位生存期11月,未治疗组的中位生存期2月,说明治疗组和未治疗组的生存期有差异。肺癌导致的呼吸循环衰竭为主要死亡原因(60.5%)。结论吸烟与支气管肺癌的发生有直接的因果关系,Ⅳ期支气管肺癌重要脏器的转移与生存期有因果关系,与转移脏器的多少无直接联系。开展健康教育,创建无烟环境,降低支气管肺癌的发生。

Clinical Analysis and Health Educational Solution for 76 Cases of Bronchogenic Carcinoma

Objective To study smoking,the metastasis,the survival duration and cause of death in patients with stage 4 bronchogenic carcinoma,in order to find a health education resolution and to improve the health standards of the community at large.Methods Retrospective study was conducted.The smoking,survival duration,the metastasis and the cause of death were analyzed of 76 cases who died of non-small cell lung cancer without an operation,as well as the relationship of these factors.Results The understanding rate of the relationship between smoking and lung cancer was 93.4%.The ratio of exposure to second-hand smoke was 100%.Adenocarcinomas was the most common pathology type in the group.Bone metastasis could spread fastest and appeared as early as 3 months.It was the most common metastasis(55.3%).It presented it self in bones as multi-metastasis.Its median survival duration was 6 months.Brain was the second most likely metastasis organ and the median survival duration was four months.The median survival duration was 11 months in the treated group while 2 months in the untreated group.It proved that there was a difference between the treated group and the untreated group in the survival duration.The main cause of death in lung cancer was respiratory circulation failure(60.5%).Conclusion There is a direct causality between smoking and lung cancer.Also a direct causality exists between the major organ metastasis and survival duration in stage 4 bronchogenic carcinoma.No direct relationship can be found between the numbers of affected organs.Multiple treatment therapy can prolong the patient's survival duration for up to a year.It is necessary to set up a non-smoking environment and launch health education campaign to reduce the incidence of lung cancer.