长期家庭氧疗对慢性阻塞性肺疾病合并慢性呼吸衰竭患者生活质量的影响研究

The effect of long-term home oxygen therapy on quality of life in COPD patients with chronic respiratory failure

目的观察长期家庭氧疗对慢性阻塞性肺疾病(COPD)合并慢性呼吸衰竭患者生活质量等参数的影响。方法我院COPD合并慢性呼吸衰竭好转出院患者81例,按出院后氧疗方式分为无创呼吸机治疗组(A组)、常规鼻导管吸氧组(B组)及未进行氧疗干预组(C组),均随访2年,观察患者病死率,对各组生存患者进一步比较,观察前后6分钟步行距离(6MWD)、改良医学研究学会呼吸困难量表(MMRC)、肺功能下降程度、氧合指数、二氧化碳分压及生活质量。比较各组复发加重次数、住院次数及住院花费等。结果 C组死亡率高于A、B组,A组死亡率最低;A、B组6 MWD、MMRC、SGRQ评分、急性发作次数、住院次数及年医疗费支出方面均优于C组,A组优于B组(P<0. 05)。结论长期家庭氧疗可明显改善患者的生活质量,降低病死率、急性发作次数及住院次数;无创通气治疗较单纯低流量吸氧具有更大的优势。

Objective To observe the effects of long-term home oxygen therapy on quality of life in patients with chronic obstructive pulmonary disease( COPD) and chronic respiratory failure.Methods Eighty-one patients with COPD and respiratory failure were discharged from our hospital. According to post-discharge oxygen therapy,the patients were divided into non-invasive ventilator treatment group(group A),conventional nasal catheter oxygenation group(group B) and no oxygen therapy intervention group(group C).The follow-up time was 2 years.The mortality rate of the patients was observed.Further comparisons were made among the surviving patients in each group including 6-minute walking distance(6 MWD),MMRC,decreased degree of pulmonary function,oxygen index,carbon dioxide partial pressure and quality of life.The number of recurrences,hospitalizations,and hospitalization costs were also compared among the groups.Results The mortality rate of the group C was higher than that of the group A and B and the group A had the lowest mortality rate.6 MWD,MMRC,SGRQ score,number of acute attacks,number of hospitalizations,and annual medical expenses in the group A and B were better or less than those in the group C(P <0. 05).Conclusion Long-term home oxygen therapy can significantly improve the quality of life in the patients and reduce the mortality rate,number of acute episodes and hospitalizations. Further,non-invasive ventilation therapy also has a greater advantage than simply low-flow oxygen therapy.