CAJ | 학술논문

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.
목적 조사비호흡과의사대폐암합병만성조새성폐질병(COPD)환자적진단치료정황,이촉진기규범진치.방법 회고성조사2009년1월지2010년12월재복단대학부속중산의원비호흡과(주요위흉외과)주원적폐암합병COPD환자,수집기출입원자료,분석일반정황、폐공능검사결과이급치료정황.결과 비호흡과접진적폐암합병COPD환자공240례,유COPD진단자5례(2.1％).은정기환자210례,안조2010년GOLD지남규범용약적공계50례(23.8％)；급성가중기환자30례,유선택지기관확장제적13례(43.3％),선택항생소적26례(86.7％),선택응용당피질격소적1례(3.3％).결론 비호흡과대폐암합병COPD환자적COPD루진정황엄중,치료불충분、불규범.
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.