【摘要】 目的　观察长期家庭氧疗对慢性阻塞性肺疾病 (COPD)低氧血症患者的疗效。方法　6 1例缓解期COPD低氧血症患者 ,分为氧疗组 30例和对照组 31例。治疗前、1年后及 2年后分别测定肺功能 ,周围血象 ,心电图 ,超声心动图 ,心理情绪评分及生命质量 (QOL)评分。两组均接受常规治疗 ,此外 ,氧疗组用双侧鼻导管家庭氧疗 ,氧流量 (0 5～ 2 5 )L min ,每日吸氧时间至少 15h。结果　 2年后氧疗组死亡 13例 ,病死率 43% ,对照组死亡 11例 ,病死率 35 % (P >0 0 5 )。氧疗组在 1年后和 2年后的血红蛋白、红细胞计数和红细胞压积与试验前比较均无明显变化。对照组 1年后的血红蛋白、红细胞计数和红细胞压积与试验前比较无明显变化 ,而 2年后血红蛋白和红细胞计数高于试验前(P <0 0 5 )。氧疗组在 1年后和 2年后心电图的RV1+SV5与试验前比较均无明显变化。而对照组 1年后和 2年后心电图的RV1+SV5均高于试验前 (P <0 0 5 ) ,2年后高于 1年后 (P <0 0 5 )。超声心动图显示氧疗组患者 1年后和 2年后的肺动脉平均压 (mPAP)较治疗前下降 (P <0 0 5 ) ,2年后亦低于 1年后 (P <0 0 5 ) ,2年后右心室流出道、右心室内径较治疗前降低 (P <0 0 5 )。对照组患者 1年后和 2年后的右心室内径、右心室流出道大于治疗前 (P <0更多还原

【Abstract】 Objective To observe the effects of long term domicilinary oxygen therapy (LTDOT) on patients of chronic obstructive pulmonary disease (COPD) with hypoxaemia Methods Sixty one hypoxemic cases with stable COPD were divided into two groups the LTDOT group of 30 patients and the control group of 31 patients Before LTDOT and one year or two years later, the lung function test, blood routine, electrocardiography and ultra echocardiography were tested, the psychological status and quality of life (QOL) were evaluated with the hospital anxiety and depression score and QOL questionnaire respectively Both groups received routine treatment In addition,the LTDOT group received oxygen therapy at home with nasal cannula with the oxygen flow of (0 5～2 5) L/min for at least 15 hrs every day Results Thirteen patients in the LTDOT group died two years later, the mortality rate was 43%; eleven patients in the control group died In LTDOT group hemoglobin, red blood cell count and hematocrit did not change after one year and two years, the hemoglobin, red blood cell count and hematocrit in the control group did not change after one year but the hemoglobin and red blood cell count increased significantly after two years ( P <0 05); ECG showed that the value of RV1+SV5 in the LTDOT group remained stable( P >0 05), which in the control group increased( P <0 05) After one year and two years, mean pulmonary artery pressure in the LTDOT group declined significantly ( P <0 05) The internal diameter of right ventricle of the heart and the outlet of right ventricle of the heart declined significantly ( P <0 05), but those in the control group increased significantly ( P <0 05) In the LTDOT group, the anxiety and depression scores were significantly improved ( P <0 05) after one year or two years, the total mean score of QOL, general activity score, social activity score, depression and anxiety scores were significantly improved ( P <0 05), but in the control group the anxiety and depression scores did not change ( P >0 05), the total mean score of QOL, social activity score, the anxiety score were significantly worse( P <0 05) Conclusions Long term domicilinary oxygen therapy could reduce the load of the right heart,improve the patients′s psychological status and quality of life更多还原