Hayashi A, Tatsumi K, Kato K, Sakuma T, Okada O, Kimura H, Kuriyama T
Department of Chest Medicine, Chiba University, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Jan;34(1):45-51.
Long-term home oxygen therapy has been shown to benefit patients with hypoxemic chronic obstructive pulmonary disease. However, to obtain the expected maximal benefit it is important for the oxygen to be used correctly and for a sufficient length of time. We examined compliance with home oxygen therapy in patients with chronic obstructive pulmonary disease, pulmonary fibrosis, late sequelae of pulmonary tuberculosis, and pulmonary hypertension who used oxygen concentrations. Compliance was defined as the ratio of the amount of oxygen used to the amount prescribed. The average daily length of time the concentrator actually ran was measured from the concentrator meters. These were read every 6 months by an engineer from the company that installed the concentrator. Factors thought to affect compliance were studied. These factors included age, the degree of dyspnea, arterial blood gases, and pulmonary function. Weak positive correlations were found between compliance and age and between compliance and PaCO2. A weak negative correlation was observed between compliance and PaO2. Compliance in patients with chronic obstructive pulmonary disease was higher than in patients with pulmonary fibrosis or pulmonary hypertension. Among those given prescriptions for 24-hr oxygen therapy, compliant patients had more severe dyspnea on excertion than did noncompliant patients. These data suggest that the compliant patients had more severe gas exchange problems.
长期家庭氧疗已被证明对低氧血症性慢性阻塞性肺疾病患者有益。然而,为了获得预期的最大益处,正确使用氧气并保证足够的时长非常重要。我们研究了慢性阻塞性肺疾病、肺纤维化、肺结核晚期后遗症和肺动脉高压且使用氧浓度的患者对家庭氧疗的依从性。依从性定义为使用的氧气量与规定的氧气量之比。通过制氧机的仪表测量制氧机实际运行的平均每日时长。这些数据每6个月由安装制氧机公司的工程师读取一次。研究了被认为会影响依从性的因素。这些因素包括年龄、呼吸困难程度、动脉血气和肺功能。发现依从性与年龄之间以及依从性与动脉血二氧化碳分压(PaCO2)之间存在弱正相关。观察到依从性与动脉血氧分压(PaO2)之间存在弱负相关。慢性阻塞性肺疾病患者的依从性高于肺纤维化或肺动脉高压患者。在那些接受24小时氧疗处方的患者中,依从性好的患者在运动时比不依从的患者有更严重的呼吸困难。这些数据表明,依从性好 的患者有更严重的气体交换问题。