[长期家庭氧疗对慢性阻塞性肺疾病低氧血症患者的影响]

Deng X, Cai Y, Fang Z

The 5th People's Hospital of Shanghai, 200240, China.

Zhonghua Jie He He Hu Xi Za Zhi. 2001 Nov;24(11):655-9.

OBJECTIVE

To observe the effects of long-term domiciliary oxygen therapy (LTDOT) on patients of chronic obstructive pulmonary disease (COPD) with hypoxaemia.

METHODS

Sixty-one hypoxemic cases with stable COPD were divided into two groups--the LTDOT group of 30 patients and the control group of 31 patents. Before LTDOT and one year or two years later, the lung function test, blood routine, electrocardiography and ultra-echocardiography were tested, the psychological status and quality of life (QOL) were evaluated with the hospital anxiety and depression score and QOL questionnaire respectively. Both groups received routine treatment. In addition,the LTDOT group received oxygen therapy at home with nasal cannula with the oxygen flow of (0.5 - 2.5) L/min for at least 15 hrs every day.

RESULTS

Thirteen patients in the LTDOT group died two years later, the mortality rate was 43%; eleven patients in the control group died. In LTDOT group hemoglobin, red blood cell count and hematocrit did not change after one year and two years, the hemoglobin, red blood cell count and hematocrit in the control group did not change after one year but the hemoglobin and red blood cell count increased significantly after two years (P < 0.05); ECG showed that the value of RV1 + SV5 in the LTDOT group remained stable (P > 0.05), which in the control group increased (P < 0.05). After one year and two years, mean pulmonary artery pressure in the LTDOT group declined significantly (P < 0.05). The internal diameter of right ventricle of the heart and the outlet of right ventricle of the heart declined significantly (P < 0.05), but those in the control group increased significantly (P < 0.05). In the LTDOT group, the anxiety and depression scores were significantly improved (P < 0.05) after one year or two years, the total mean score of QOL, general activity score, social activity score, depression and anxiety scores were significantly improved (P < 0.05), but in the control group the anxiety and depression scores did not change (P > 0.05), the total mean score of QOL, social activity score, the anxiety score were significantly worse(P < 0.05).

CONCLUSIONS

Long-term domiciliary oxygen therapy could reduce the load of the right heart, improve the patients's psychological status and quality of life.

目的

观察长期家庭氧疗（LTDOT）对慢性阻塞性肺疾病（COPD）合并低氧血症患者的影响。

方法

将61例病情稳定的COPD低氧血症患者分为两组，长期家庭氧疗组30例，对照组31例。在长期家庭氧疗前、治疗1年及2年后，分别进行肺功能、血常规、心电图及超声心动图检查，并用医院焦虑抑郁量表及生活质量（QOL）问卷评估患者心理状态及生活质量。两组均接受常规治疗。此外，长期家庭氧疗组在家中采用鼻导管吸氧，氧流量为（0.5 - 2.5）L/min，每天至少吸氧15小时。

结果

长期家庭氧疗组2年后死亡13例，死亡率为43%；对照组死亡11例。长期家庭氧疗组1年及2年后血红蛋白、红细胞计数及血细胞比容无变化，对照组1年后血红蛋白、红细胞计数及血细胞比容无变化，但2年后血红蛋白及红细胞计数显著升高（P < 0.05）；心电图显示，长期家庭氧疗组RV1 + SV5值保持稳定（P > 0.05），对照组升高（P < 0.05）。1年及2年后，长期家庭氧疗组平均肺动脉压显著下降（P < 0.05），右心室内径及右心室流出道显著缩小（P < 0.05），而对照组则显著增大（P < 0.05）。长期家庭氧疗组1年或2年后焦虑抑郁评分显著改善（P < 0.05），生活质量总分、一般活动评分、社会活动评分、抑郁及焦虑评分均显著改善（P < 0.05），而对照组焦虑抑郁评分无变化（P > 0.05），生活质量总分、社会活动评分、焦虑评分显著变差（P < 0.05）。