Marien H, Marchand E
Service de pneumologie, CHU de Mont-Godinne, université catholique de Louvain,1, avenue Dr-Therasse, 5530 Yvoir, Belgique.
Rev Mal Respir. 2011 Sep;28(7):873-80. doi: 10.1016/j.rmr.2011.05.002. Epub 2011 Jul 23.
The provision of ambulatory oxygen in addition to a stationary oxygen supply has been suggested to increase adherence to long-term oxygen therapy (LTOT) and promote ambulation. The degree of adherence to ambulatory oxygen therapy and the determinants of adherence remain largely unknown.
These were assessed in patients treated with LTOT (oxygen concentrator plus small oxygen cylinders with a demand oxygen delivery system [DODS]) in a tertiary care hospital supplied according to the Belgian criteria for LTOT refunding. Adherence to ambulatory oxygen was defined as mean use of ambulatory oxygen greater than 30 min/day. Patients' files were reviewed and a questionnaire was sent for assessing patients' view on the use of ambulatory oxygen.
Forty-six patients were included. Mean use of ambulatory oxygen was 40±36min/day. Twenty-three patients were adherent to ambulatory oxygen according to our definition. There was no difference between adherent and non-adherent patients regarding lung function or blood gases, nor was there any correlation between mean daily ambulatory oxygen use and any parameter. However, patients with MMRC 4 dyspnoea scale had a significantly lower use of ambulatory oxygen than patients with less severe dyspnoea (mean 33±24 vs 42±39min/day ; P=0.03) despite self reporting better adherence to LTOT.
Adherence to ambulatory oxygen in this series of patients is quite low but at the higher end of data reported previously. Patients with MMRC 4 dyspnoea scale had a lower use of ambulatory oxygen despite reporting better adherence to LTOT. We could not identify any other predictive factors of adherence to ambulatory oxygen.
除了固定氧气供应外，提供便携式氧气被认为可以提高长期氧疗（LTOT）的依从性并促进活动能力。便携式氧疗的依从程度及其决定因素在很大程度上仍不清楚。
在一家按照比利时LTOT报销标准提供服务的三级医院中，对接受LTOT治疗（氧气浓缩器加带有按需氧气输送系统[DODS]的小型氧气瓶）的患者进行了评估。便携式氧气的依从性定义为便携式氧气的平均使用时间大于每天30分钟。查阅了患者档案，并发送了一份问卷以评估患者对使用便携式氧气的看法。
纳入了46名患者。便携式氧气的平均使用时间为40±36分钟/天。根据我们的定义，有23名患者坚持使用便携式氧气。在依从和不依从的患者之间，肺功能或血气方面没有差异，平均每日便携式氧气使用量与任何参数之间也没有相关性。然而，尽管自我报告对LTOT的依从性更好，但与呼吸困难较轻的患者相比，MMRC 4级呼吸困难量表的患者便携式氧气的使用量明显更低（平均33±24 vs 42±39分钟/天；P=0.03）。
在这组患者中，便携式氧气的依从性相当低，但处于先前报道数据的较高水平。MMRC 4级呼吸困难量表的患者尽管报告对LTOT的依从性更好，但便携式氧气的使用量较低。我们无法确定任何其他便携式氧气依从性的预测因素。
