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[慢性呼吸衰竭患者的肺血流动力学与家庭氧疗]

[Pulmonary hemodynamics and home oxygen therapy in patients with chronic respiratory failure].

作者信息

Kubo S, Yasuoka A, Rikitake T, Shimoda T, Fujita K, Nakatomi M, Hara K

机构信息

Department of Medicine, National Sanatorium Nagasaki Hospital, Japan.

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Sep;29(9):1161-7.

PMID:1753543
Abstract

The authors examined pulmonary hemodynamics with respect to underlying diseases, severity and type of chronic respiratory failure, and the incidence and effect of home oxygen therapy (HOT) in 155 patients with chronic lung diseases (old pulmonary tuberculosis (OTB) 45, chronic pulmonary emphysema (CPE) 54, chronic bronchitis (CBR) 42 and fibrosing lung disease (FLD) 14). They underwent right heart catheterization during a stable period, while breathing room air. The arterial PO2 ranged from 64.3 +/- 9.7 Torr (CBR) to 69.9 +/- 10.0 Torr (CPE), and the mean pulmonary arterial pressure ranged from 17.3 +/- 4.6 mmHg (CPE) to 20.6 +/- 5.4 mmHg (OTB). The incidence of pulmonary hypertension (PH, PA mean greater than or equal to 20 mmHg) was 53.3% in OTB, 40% in CBR, 35.7% in FLD, 23.8% in CPE, 69% in respiratory failure, 40% in quasi-respiratory failure, and 2.1% in non-respiratory failure. The percentage of patients who received HOT was 84.5% in respiratory failure and 54.1% in quasi-respiratory failure. Comparing Type I with Type II chronic respiratory failure, the incidence of PH was lower in the former than the latter (38.3% vs 80.6%), whereas HOT was applied to an equal percentage of patients (67.4%) in both groups. The effect of HOT was evaluated in 11 patients with chronic respiratory failure. The mean pulmonary arterial pressure was 22.7 +/- 4.7 mmHg before HOT, and decreased to 20.7 +/- 5.6 mmHg after 24.5 +/- 10.1 months of HOT. Although this difference was not significant statistically, this result suggests the desirable effect of HOT on pulmonary hemodynamics.

摘要

作者对155例慢性肺部疾病患者(陈旧性肺结核45例、慢性肺气肿54例、慢性支气管炎42例、肺纤维化疾病14例)的肺血流动力学进行了研究,研究内容涉及基础疾病、慢性呼吸衰竭的严重程度和类型以及家庭氧疗(HOT)的发生率和效果。在呼吸室内空气的稳定期,他们接受了右心导管检查。动脉血氧分压范围为64.3±9.7托(慢性支气管炎)至69.9±10.0托(慢性肺气肿),平均肺动脉压范围为17.3±4.6毫米汞柱(慢性肺气肿)至20.6±5.4毫米汞柱(陈旧性肺结核)。肺动脉高压(PH,肺动脉平均压大于或等于20毫米汞柱)的发生率在陈旧性肺结核中为53.3%,慢性支气管炎中为40%,肺纤维化疾病中为35.7%,慢性肺气肿中为23.8%,呼吸衰竭中为69%,准呼吸衰竭中为40%,非呼吸衰竭中为2.1%。接受家庭氧疗的患者百分比在呼吸衰竭中为84.5%,在准呼吸衰竭中为54.1%。比较I型和II型慢性呼吸衰竭,前者的肺动脉高压发生率低于后者(38.3%对80.6%),而两组中接受家庭氧疗的患者百分比相同(67.4%)。对11例慢性呼吸衰竭患者评估了家庭氧疗的效果。家庭氧疗前平均肺动脉压为22.7±4.7毫米汞柱,经过24.5±10.1个月的家庭氧疗后降至20.7±5.6毫米汞柱。虽然这一差异在统计学上不显著,但该结果表明家庭氧疗对肺血流动力学有预期效果。

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