长期家庭氧疗对慢性肺源性心脏病的作用研究

Study on influence of long-term home oxygen therapy on patients with chronic pulmonary heart disease

目的 观察长期家庭氧疗对慢性肺心病患者的疗效及远期预后的影响.方法 对52例慢性肺心病患者按就诊顺序随机分为氧疗组27例和对照组25例,分别测定试验前,1.5年后及3年后的心电图EKG、超声心动图UCG 、外周血相血RT及3年存活率,两组均接受常规治疗,氧疗组用双侧鼻导管每日持续给氧气10～15h,氧流量1～2L/min.对照组不吸氧或急性发作时仅间段短时间吸氧.结果 心电图变化显示 1.5年后及3年后较试验前RV1＋SV5均无明显变化,对照组1.5年后及3年后RV1＋SV5均高于试验前且3年后高于1.5年后,超声心动图显示氧疗组1.5年后及3年后的肺动脉压mPAP较试验前下降,3年后亦低于1.5年后,3年后右室内径、流出道内径较治疗前降低,对照组患者1.5年后3年后上二者均大于试验前.3年后mPAP较1.5年后增加.3年后病死率氧疗组为29.6%,对照组为36%.结论 长期家庭氧疗能降低肺动脉压,减轻右心负荷,改善心功能,提高生活质量及生存率.

Objective To observe the curative effect and long-term prognostic influence of long-term home oxygen therapy on patients with chronic pulmonary heart disease. Methods According to registration and visiting time, 52 patients with chronic pulmonary heart disease were randomly divided into the oxygen therapy group （27 patients） and the control group （25 patients）, and tested on EKG, UCG, RT before experiment, 1.5 years and 3 years after experment respectively, and the survival in 3 years. Both groups were given routine treatment. Every day, oxygen was provided to the oxygen therapy group by double tubes for 10-15h at 1-2L/min. No oxygen inhalation for the control group was given or oxygen inhalation was only given for a short time at paroxysm. Results The change of EKG showed that there was no obvious change in RV1 and SV5 of the oxygen therapy group in 1.5 years and 3 years after experiment,compared with the data before experiment. However, RV1 and SV5 of the control group were higher in 1.5 and 3 years after experiment than before experiment, and the number in 3 years wa.s higher than that in 1.5 years. UCG showed that mean pulmonary artery pressure （MPAP） of the oxygen therapy group was reduced in 1.5 years and 3 years, compared with that of before experiment, and the number in 3 years was lower than in 1.5 years. In 3 years, right ventricular diameter and outflow tract were reduced after therapy while the two numbers of control group were larger than before experiment, and MPAP was increased in 3 years from 1.5 years. In 3 years, the morality rate of the oxygen therapy group and the confrol group accounted for 29.6%-36% respectively. Conclusion The long-term oxygen therapy can reduce MPAP,lessen the burden of right ventricular, improve heart function and lift the quality of life.