肺癌共病症－以台灣全國人口為對象之研究

Comorbidities in lung cancer: a nationwide population-based study in Taiwan

背景與目的：肺癌無論在全世界或台灣都是導致癌症病人死亡的主要原因之一，許多肺癌病患會因為共病性的緣故而影響其存活率。這項回朔性研究是利用台灣全民健保資料庫建立的研究族群來探究肺癌病人的共病性危險因子。方法：全民健康保險（NHI）為一項強制性的全民醫療保險計畫，可提供台灣居民全面的醫療服務。本研究使用2000年承保抽樣歸人檔（LHID 2000）分別出有無罹患肺癌的組別。肺癌共病性的風險評估是透過比較有無其他疾病的肺癌病患之勝算比值（odds ratios）。結果：本研究包含3,799 位肺癌病例組及15,196位對照組。分析結果顯示，肺癌病例組與多種肺部疾病及其他系統性疾病，如：胃和十二指腸潰瘍、肝膽胰疾病、細菌感染及菌血症等皆有較高的共病性（P < 0.05）。此外，勝算比值分析結果亦顯示女性肺癌病人有胸膜炎的共病性風險要高於男性（OR =9.33 vs. 4.69; P< 0.001）。結論：研究結果顯示肺癌的共病性風險並不僅限於肺部疾病而已，亦會與其他的器官及系統疾病相關。未來仍須利用更多族群樣本的分析來確認此研究結果。

 

Background: The concept of enhanced recovery after surgery (ERAS) is flourishing in multiple specialties, including cardiac surgery. Beside minimally invasive surgical approach, short acting anesthetic agent is one of the major components of ERAS programs. Remifentanil is an ultrashort acting opioid agent. The purpose of this study was to compare remifentanil and low dose fentanyl for postoperative recovery profile in patients undergoing minimally invasive cardiac surgery (MICS). Methods: This study was a retrospective study. We compared the recovery profile including extubation time after surgery, length of hospital stay, postoperative morphine consumption, pain scores and in hospital complication rate between patients undergoing elective MICS from May to August 2018. Results: Fifty-three patients were enrolled in this study, 33 of them were in group remifentanil (G. remifentanil) and 20 were in group fentanyl (G. fentanyl). The extubation times, average hospital stay, postoperative morphine consumption, pain scores and in hospital complication rate were all similar between both groups. Conclusion: We consider remifentanil can be safely used in MICS and provides similar recovery profile as low dose fentanyl.