Tiep Brian, Carter Rick, Zachariah Finly, Williams Anna C, Horak David, Barnett Mary, Dunham Rachel
City of Hope National Medical Center, Duarte, California, USA.
Expert Rev Respir Med. 2013 Oct;7(5):479-90. doi: 10.1586/17476348.2013.816565.
Oxygen is commonly prescribed for lung cancer patients with advancing disease. Indications include hypoxemia and dyspnea. Reversal of hypoxemia in some cases will alleviate dyspnea. Oxygen is sometimes prescribed for non-hypoxemic patients to relieve dyspnea. While some patients may derive symptomatic benefit, recent studies demonstrate that compressed room air is just as effective. This raises the question as to whether to continue their oxygen. The most efficacious treatment for dyspnea is pharmacotherapy-particularly opioids. Adjunctive therapies include pursed lips breathing and a fan blowing toward the patient. Some patients may come to require high-flow oxygen. High-flow delivery devices include masks, high-flow nasal oxygen and reservoir cannulas. Each device has advantages and drawbacks. Eventually, it may be impossible or impractical to maintain a SpO2 > 90%. The overall goal in these patients is comfort rather than a target SpO2. It may eventually be advisable to remove continuous oximetry and transition focus to pharmacological management to achieve patient comfort.
对于病情进展的肺癌患者，通常会开具吸氧处方。适应症包括低氧血症和呼吸困难。在某些情况下，纠正低氧血症可缓解呼吸困难。有时也会为非低氧血症患者开具吸氧处方以缓解呼吸困难。虽然一些患者可能会从症状改善中获益，但最近的研究表明，压缩室内空气同样有效。这就引发了是否要继续吸氧的问题。治疗呼吸困难最有效的方法是药物治疗，尤其是使用阿片类药物。辅助治疗包括缩唇呼吸和向患者吹风。一些患者可能最终需要高流量吸氧。高流量输送设备包括面罩、高流量鼻导管吸氧和储氧面罩。每种设备都有优缺点。最终，可能无法或不实际维持血氧饱和度>90%。这些患者的总体目标是舒适，而非目标血氧饱和度。最终，可能建议移除连续血氧监测，并将重点转向药物管理以实现患者舒适。
