Crockett A J, Cranston J M, Moss J R, Alpers J H
Respiratory Unit, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, AUSTRALIA, 5042.
Cochrane Database Syst Rev. 2000(4):CD001744. doi: 10.1002/14651858.CD001744.
Domiciliary oxygen therapy has become one of the major forms of treatment for hypoxaemic chronic obstructive pulmonary disease (COPD) patients.
To determine the effect of domiciliary oxygen therapy on survival and quality of life in patients with COPD.
Randomised controlled trials (RCTs) were identified using the Cochrane Airways Group COPD register using the search terms: home OR domiciliary AND oxygen.
Any RCT in patients with hypoxaemia and COPD that compared long term domiciliary or home oxygen therapy with a control treatment.
Data extraction was performed independently by two reviewers.
Five randomised controlled trials were identified. Data was aggregated from two trials of the treatment of nocturnal oxygen therapy in patients with mild to moderate COPD and arterial desaturation at night. Data could not be aggregated for the other three trials because of differences in trial design and patient selection. Nott 1980: continuous oxygen therapy versus nocturnal oxygen therapy: there was a significant improvement in mortality after 24 months (Peto odds ratio 0.45, 95% confidence interval 0.25 to 0.81). MRC 1981: domiciliary oxygen therapy versus no oxygen therapy: there was a significant improvement over five years in mortality in the group receiving oxygen therapy (Peto odds ratio 0.42, 95% confidence interval 0.18 to 0.98). In two studies of nocturnal oxygen versus no oxygen in patients with COPD and arterial desaturation at night: there was no difference in mortality between treated and non treated groups for either trial or when the trials were aggregated. In one study of long term oxygen versus no oxygen in moderate hypoxaemia: there was no effect on survival for up to three years of follow up.
REVIEWER'S CONCLUSIONS: Long term oxygen therapy improved survival in a selected group of COPD patients with severe hypoxaemia (arterial PO2 less than 8.0 kPa). Long term oxygen did not appear to improve survival in patients with moderate hypoxaemia or in those with only arterial desaturation at night.
家庭氧疗已成为低氧血症慢性阻塞性肺疾病（COPD）患者的主要治疗方式之一。
确定家庭氧疗对COPD患者生存率和生活质量的影响。
使用Cochrane Airways Group COPD登记册，通过检索词“家庭或住所”和“氧气”来识别随机对照试验（RCT）。
任何针对低氧血症和COPD患者的RCT，比较长期家庭或住所氧疗与对照治疗。
由两名审阅者独立进行数据提取。
确定了五项随机对照试验。数据来自两项针对轻度至中度COPD且夜间动脉血氧饱和度降低患者的夜间氧疗试验。由于试验设计和患者选择的差异，其他三项试验的数据无法汇总。诺特1980年试验：持续氧疗与夜间氧疗比较：24个月后死亡率有显著改善（Peto比值比0.45，95%置信区间0.25至0.81）。医学研究委员会1981年试验：家庭氧疗与无氧疗比较：接受氧疗组在五年内死亡率有显著改善（Peto比值比0.42，95%置信区间0.18至0.98）。在两项针对COPD且夜间动脉血氧饱和度降低患者的夜间吸氧与不吸氧研究中：无论是单个试验还是汇总试验，治疗组和未治疗组的死亡率均无差异。在一项针对中度低氧血症患者的长期吸氧与不吸氧研究中：长达三年的随访期内对生存率无影响。
长期氧疗可改善一组选定的重度低氧血症（动脉血氧分压低于8.0 kPa）COPD患者的生存率。长期氧疗似乎并未改善中度低氧血症患者或仅夜间动脉血氧饱和度降低患者的生存率。
