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目的:观察长程氧疗对慢性阻塞性肺疾病(COPD)低氧血症患者的疗效。方法:46例缓解期COPD低氧血症患者,分为氧疗组21例和对照组25例。治疗前、2年后和3年后分别测定周围血象、心电图、超声心动图、肺功能。两组均接受常规治疗外,氧疗组接受家庭长程氧疗,氧流量1～2.5L/min,每日吸氧时间不少于15小时。结果:3年后氧疗组的死亡率为28％,对照组的死亡率为36％,两组比较无显著差异性(P>0.05);氧疗组2年后和3年后的血红蛋白、红细胞压积、红细胞计数均优于对照组(P<0.05)。氧疗组2年后和3年后心电图RV_1+SV_5均低于对照组(P<0.05)。超声心动图显示氧疗组患者2年后和3年后的肺动脉平均压(mPAP)及右心室内径均较治疗前有显著下降(P<0.05);而对照组2年后和3年后的肺动脉平均压及右心室内径均较治疗前有显著增加(P<0.05);氧疗组2年后和3年后的的肺功能指标FEV_1％反右心功能亦好于对照组(P<0.05)。结论:长程家庭氧疗能减轻心脏负荷、改善心功能,提高生命质量。
Objective: To observe the effect of long-term oxygen therapy on patients with chronic obstructive pulmonary disease (COPD) hypoxemia. Methods: Forty-six patients with COPD hypoxemia were divided into oxygen therapy group (n = 21) and control group (n = 25). Peripheral blood, electrocardiogram, echocardiography and pulmonary function were measured before treatment, 2 years and 3 years later. Both groups received routine treatment, oxygen therapy group received long-term home oxygen therapy, oxygen flow 1 ~ 2.5L / min, oxygen daily oxygen time of not less than 15 hours. Results: The mortality of oxygen therapy group was 28% after 3 years and that of control group was 36%, there was no significant difference between the two groups (P> 0.05). After 2 years and 3 years, the hemoglobin, Hematocrit and erythrocyte count were better than the control group (P <0.05). The levels of RV_1 + SV_5 in the oxygen therapy group after 2 years and 3 years were lower than those in the control group (P <0.05). Echocardiography showed that pulmonary artery mean pressure (mPAP) and right ventricular internal diameter decreased significantly (P <0.05) in oxygen therapy group two years later and three years later, while those in control group two years later and three years later Mean pulmonary artery pressure and right ventricular diameter were significantly higher than those before treatment (P <0.05). FEV_1% anti-right heart function was also better in the oxygen therapy group than in the control group after 2 years and 3 years (P <0.05 ). Conclusion: Long-term home oxygen therapy can reduce the heart load, improve heart function and improve the quality of life.