Comportamento da função cardiorrespiratória e muscular de pacientes com câncer submetidos à cirurgia abdominal oncológica
Data
2018-02-26
Autores
Moreira, Patrícia Sandei Galvão [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Os pacientes com câncer podem apresentar sintomas pulmonares incapacitantes como dispneia, fadiga e intolerância ao exercício. Considerando que um dos principais tratamentos para essa patologia é a cirurgia, os profissionais devem atentar-se às complicações pós-operatórias (CPO) que estão presentes principalmente nas cirurgias abdominais e torácicas, já que interferem na função muscular e na mecânica respiratória. OBJETIVO: Analisar se a doença oncológica leva a alterações na função cardiorrespiratórias e musculares, avaliar o comportamento da função cardiorrespiratória e da força muscular de pacientes oncológicos submetidos à cirurgia abdominal aberta e identificar os fatores pré-operatórios que podem diferenciar as CPO em pacientes oncológicos submetidos a cirurgia abdominal aberta. METODOLOGIA: Os pacientes foram divididos em dois grupos: grupo experimental (GE) composto por pacientes com diagnóstico de câncer abdominal e grupo controle (GC) com pacientes saudáveis. Na avaliação passaram por anamnese, testes de esforço, teste da função e força pulmonar e teste de força de preensão manual. Considerou-se estatisticamente significante p<0,05. RESULTADOS: Foram avaliados 33 pacientes (19 mulheres) em cada grupo. Quando comparado os pacientes do GC e do GE, observou-se diferença estatística na PImax (%) e na distância percorrida no ISWT (%). Os pacientes que não complicaram no quinto dia de pós-operatório (PO5) ou no trigésimo dia de pós-operatório (PO30) tiveram as variáveis pré-operatórias (PRÉ) comparadas com PO5 ou PO30, respectivamente. Na primeira situação, observou-se que houve diferença estatística em CVF, VEF1, PEF, FEF25-75%, valores reais e (%), VEF1/CVF (%), PImax em valor real e PEmax e ISWT reais e em (%). Já os momentos PRÉ e PO30 sem CPO a diferença foi observada nas variáveis: distância do ISWT real e (%). Quando comparados todos os momentos de pacientes que não complicaram a diferença foi significante em CVF e VEF1 (%), PEF real e distância do ISWT real e (%). E por último foi comparado os momentos PRÉ dos pacientes que não tiveram CPO no PO5 com o PRÉ dos pacientes que tiveram CPO no PO5 e o momento PRÉ dos pacientes sem CPO no PO30 com o momento PRÉ dos pacientes com CPO no PO30. Na primeira situação observou-se diferença estatística em FEF25-75%, real e na distância do ISWT real e (%). Já na segunda situação foi observada diferença estatística em CVF, PFE e FEF25-75% reais e em VEF1 e ISWT reais e (%). CONCLUSÃO: Podemos concluir que a doença oncológica abdominal, assim como a cirurgia abdominal, levam a alterações funcionais cardiorrespiratórias e musculares. E que as variáveis espirométricas, o teste de esforço e a frequência cardíaca foram capazes de diferenciar pacientes que não complicam daqueles que complicam.
Cancer patients may present some disabling pulmonary symptoms such as dyspnea, fatigue and exercise intolerance. Considering that surgery is one of the main treatments for this pathology, professionals should pay attention to postoperative complications (POC) which are present mainly in abdominal and thoracic surgeries, since they interfere in muscle function and respiratory mechanics. OBJECTIVE: To analyze whether oncological disease leads to cardiorespiratory and muscular function disturbance, to evaluate the behavior of cardiorespiratory function and muscular strength in cancer patients submitted to open abdominal surgery and to identify preoperative factors that may differentiate PCO in oncological patients submitted open abdominal surgery. METHODOLOGY: Patients were divided into two groups: experimental group (EG) composed of patients with abdominal cancer and control group (CG) with healthy patients. The evaluation submitted both groups to anamnesis, stress tests, function test and pulmonary force and manual grip strength test. A value for p <0.05 was considered statistically significant. RESULTS: Thirty-three patients (19 women) were evaluated in each group. When comparing CG and EG patients, a statistical difference was observed in the MIP (%) and the distance covered in the ISWT (%). Patients who did not complicate on the fifth postoperative day (PO5) or on the 30th postoperative day (PO30) had the preoperative variables (PRÉ) compared to PO5 or PO30, respectively. In the first situation, it was observed that there was a statistical difference in FVC, FEV1, PEF, FEF(25-75%), real values and (%), FEV1/FVC (%), real MIP and real and (%) MEP, ISWT. In PRE and PO30 moments without PCO, the difference was observed in the variables: distance from the real ISWT and (%). When comparing all the moments of patients who did not complicate the difference was significant in FVC and FEV1 (%), real PEF and ISWT real and (%) distance. Finally, we compared the PRE moments of the patients who did not have POC in the PO5 with the PRE of the patients who had POC in the PO5 and the PRE moments of the patients without POC in the PO30 with the PRÉ moment of the patients with POC in the PO30. In the first situation, we observed a statistical difference in FEF(25-75%), real and in the distance of the real and (%) ISWT. In the second situation, a statistical difference was observed in real FVC, PEF and FEF(25-75%), and in FEV1 and ISWT real and (%). CONCLUSION: We can conclude that abdominal cancer, as well as abdominal surgery, lead to cardiorespiratory and muscular functional changes. And that the spirometric variables, the stress test and the heart rate were able to differentiate patients that do not complicate to those that complicate.
Cancer patients may present some disabling pulmonary symptoms such as dyspnea, fatigue and exercise intolerance. Considering that surgery is one of the main treatments for this pathology, professionals should pay attention to postoperative complications (POC) which are present mainly in abdominal and thoracic surgeries, since they interfere in muscle function and respiratory mechanics. OBJECTIVE: To analyze whether oncological disease leads to cardiorespiratory and muscular function disturbance, to evaluate the behavior of cardiorespiratory function and muscular strength in cancer patients submitted to open abdominal surgery and to identify preoperative factors that may differentiate PCO in oncological patients submitted open abdominal surgery. METHODOLOGY: Patients were divided into two groups: experimental group (EG) composed of patients with abdominal cancer and control group (CG) with healthy patients. The evaluation submitted both groups to anamnesis, stress tests, function test and pulmonary force and manual grip strength test. A value for p <0.05 was considered statistically significant. RESULTS: Thirty-three patients (19 women) were evaluated in each group. When comparing CG and EG patients, a statistical difference was observed in the MIP (%) and the distance covered in the ISWT (%). Patients who did not complicate on the fifth postoperative day (PO5) or on the 30th postoperative day (PO30) had the preoperative variables (PRÉ) compared to PO5 or PO30, respectively. In the first situation, it was observed that there was a statistical difference in FVC, FEV1, PEF, FEF(25-75%), real values and (%), FEV1/FVC (%), real MIP and real and (%) MEP, ISWT. In PRE and PO30 moments without PCO, the difference was observed in the variables: distance from the real ISWT and (%). When comparing all the moments of patients who did not complicate the difference was significant in FVC and FEV1 (%), real PEF and ISWT real and (%) distance. Finally, we compared the PRE moments of the patients who did not have POC in the PO5 with the PRE of the patients who had POC in the PO5 and the PRE moments of the patients without POC in the PO30 with the PRÉ moment of the patients with POC in the PO30. In the first situation, we observed a statistical difference in FEF(25-75%), real and in the distance of the real and (%) ISWT. In the second situation, a statistical difference was observed in real FVC, PEF and FEF(25-75%), and in FEV1 and ISWT real and (%). CONCLUSION: We can conclude that abdominal cancer, as well as abdominal surgery, lead to cardiorespiratory and muscular functional changes. And that the spirometric variables, the stress test and the heart rate were able to differentiate patients that do not complicate to those that complicate.
Descrição
Palavras-chave
Teste de esforço, Força muscular, Teste de função respiratória, Neoplasia, Exercise test, Muscle strength, Respiratory function tests