Domingo C, Coll R, Izquierdo J, Roig J, Klamburg J, Domingo E, Moreno J A, Morera J
Servicio de Neumología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona.
Arch Bronconeumol. 1995 Jan;31(1):13-7. doi: 10.1016/s0300-2896(15)30981-9.
We studied clinical tolerance, complications, change in pulmonary function test results, arterial gasometrics, hemoglobin (Hb), 6 minute stress tests (6 wt) and subjective perception of dyspnea assessed on a visual analog scale (VAS) in a group of 18 patients (17 with obstructive disease and one with restrictive disease). These patients had previously been enrolled in a home oxygen therapy (HOT) program to deliver continuous oxygen therapy through nasal prongs, and had accepted portable oxygen therapy delivered by transtracheal catheter (TTC) from 1988 until 1993. Tolerance was good, there were no lethal complications of TTC, and excellent compliance with the prescribed HOT was achieved. Lung function test results worsened, while Hb and PaO2 improved and significant oxygen savings (50%) were achieved. The 6 wt test results had not worsened at the end of the first year but did so significantly at the end of the third year, in spite of a relative preservation of lung function. Dyspnea assessed on a VAS was not seen to worsen. We conclude that tolerance of the method was good and that no relevant complications occurred. HOT by TTC did not prevent worsening of bronchial obstruction. Oxygenation of patients was better, as shown by the decrease in Hb and the improvement in PaO2 at the end of the first year of monitoring. Changes in 6 wt showed that in order to achieve greater benefit from HOT by TTC, patients should follow a pulmonary rehabilitation program.
我们研究了18例患者(17例阻塞性疾病患者和1例限制性疾病患者)的临床耐受性、并发症、肺功能测试结果变化、动脉血气分析、血红蛋白(Hb)、6分钟步行试验(6MWT)以及采用视觉模拟量表(VAS)评估的呼吸困难主观感受。这些患者此前已参加家庭氧疗(HOT)项目,通过鼻导管接受持续氧疗,并于1988年至1993年接受经气管导管(TTC)提供的便携式氧疗。耐受性良好,TTC无致命并发症,且对规定的HOT依从性极佳。肺功能测试结果恶化,而Hb和动脉血氧分压(PaO2)改善,且显著节省了50%的氧气。6MWT测试结果在第一年结束时未恶化,但在第三年结束时显著恶化,尽管肺功能相对保持。通过VAS评估的呼吸困难未见恶化。我们得出结论,该方法耐受性良好,未发生相关并发症。TTC进行的HOT未能阻止支气管阻塞的恶化。监测第一年结束时,Hb降低和PaO2改善表明患者的氧合情况更好。6MWT的变化表明,为了从TTC进行的HOT中获得更大益处,患者应遵循肺康复计划。