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肺康复和癌症设置:是有益的吗?它是安全的呢?薇琪R香农,美国德克萨斯大学MD安德森癌症中心
文摘
癌症是一个集合的名字相关的疾病。在所有类型的癌症,身体的一些细胞开始分裂没有停止和扩散到周围组织。人体癌症可以几乎任何地方,这是由数十亿的细胞。正常情况下,人体细胞生长和分裂形成新的细胞当身体需要他们。随着细胞年龄或受损,他们死,新细胞代替了他们的位置。当癌症生长,然而,这种有序的过程分解。随着细胞变得越来越不正常,旧的或损坏的细胞存活他们应该死后,当他们不需要和新细胞形成。没有停止这些额外的细胞可以分裂并形成增生称为肿瘤。许多癌症形成实体瘤,肿块的组织。血液癌症,如白血病,通常并不会形成实体肿瘤。 Cancerous tumors are malignant, which means they can spread or invade nearby tissue. Also, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or lymphatic system and form new tumors far from the original tumor. Statement of the Problem: Evidence-based support for pulmonary rehabilitation (PR) in the management of patients with chronic lung disease has grown significantly. A beneficial role has been widely demonstrated in patients with chronic obstructive pulmonary disease (COPD) and patients with pulmonary emphysema enrolled for lung volume reduction surgery. In these settings, significant reductions in dyspnea and improvements in physical performance and health-related quality of life have been demonstrated following a PR program. PR is often advocated as an adjunct to cancer patients. Small recent studies suggest that RA may have a favorable impact on the management of lung cancer by improving a variety of clinically significant outcomes, such as performance status, chemotherapy-related fatigue, oxygen uptake, exercise tolerance and health-related quality of life. However, the true benefits and safety of this intervention in the context of cancer remain in question. Purpose of the Study: To determine the role and safety of RP in the improvement of chronic symptoms of dyspnea, fatigue and / or exercise intolerance in patients with hematologic and solid malignancies. Methods: Patients with active hematologic or solid tumors who were referred to the pulmonary service for evaluation of chronic dyspnea and / or decreased functional status were placed in our outpatient PR program and studied prospectively. Baseline clinical assessment and functional status including 6 minute walking distance (6 MWD), cardiopulmonary stress tests (CPET), and self-reports of perceived exertion and dyspnea were been used to develop an individualized exercise prescription and public relations program for each patient. All studies were repeated at the end of the program. The 12-week program included progressive aerobic and resistance training sessions three times per week and weekly educational and psychosocial training components. Results: Participation in the RP program significantly increased 6 MWD mean distance (23%, P <0.05) and oxygen uptake, as assessed by VO2 (18.6%, P <0.05). Dyspnea and perceived exertion scores were similar before and after rehabilitation despite greater physiological work after rehabilitation. Significant improvements were observed in patients with liquid and solid malignant tumors. No adverse events occurred during the study. Conclusion: Pulmonary rehabilitation appears safe and promising as a therapeutic intervention in the management of a heterogeneous population of oncology patients presenting debilitating pulmonary symptoms
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