家庭长期氧疗对慢性阻塞性肺病患者生活质量的影响

The Effect of Long Term Domiciliary Oxygen Therapy on the Life Quality of Chronic Obstructive Pulmonary Disease

目的 :探讨家庭长期氧疗 (LTDOT)对慢性阻塞性肺病 (COPD)患者躯体功能、心理情绪及社会活动能力的影响。方法 :对 30例COPD稳定期患者施以长期家庭氧疗 ,于氧疗前及氧疗后 (随访 3年 )每年 1次 ,测定一秒用力呼吸容积 (FEV1)、动脉血氧分压 (PaO2 )、动脉血二氧化碳分压 (PaCO2 ) 6分钟步行距离 (6MWD) ;用修订医学研究委员会呼吸困难评分标准对呼吸困难进行评价 ;用汉密顿抑郁量表 (HRSD)及汉密顿焦虑量表 (HAMA)进行心理状态评定 ;用老年人社交情况问卷表进行社会生活能力评定。结果 :氧疗后 1、2、3年与氧疗前 (基础值 )比较FEV1、PaO2 、6MWD明显提高 (P <0 0 1) ;呼吸困难分级评分明显降低 (P <0 0 1) ;社交情况评分明显提高 (P <0 0 1) ;HRSD及HAMA评分无明显变化 (P≥ 0 0 5 )。结论 :LTDOT能使COPD患者PaO2 保持较高水平 ,肺功能得以改善 ,改善呼吸困难程度 ,提高活动耐力 ,增加活动范围 ,改善社会活动能力 ,使COPD患者生活质量得以改善。

Objective:To explore the effect of the quality of life chronic obstructive pulmonary disease(COPD)such as stature function,psychologqical feeling and the ability of social action by long term do miciliary oxygen therapy(LTDOT).Method:Administering LTDOT on 30 stable patients with COPD,forced expiratory volume in one second(FEV 1),arterial oxygen pres sure(PaO 2),arterial carbon dioxide pressure(PaCO 2),walking distance in 6 minutes(6MWD)were measured before and after oxygen therapy once a year for 3 ye ars.Use the respiration difficulty criteria of the Medical Investigating Committ ee,questionaire of the elderly social intercourse,Hamilton Depression Rating Sca le(HRSD)and Hamilton Anxiety Scale(HAMA)to evaluate respiration difficulty,psych ological condition,the ability of social life respectively.Results:Comparison be tween before and after oxygen therapy(1st,2nd,3rd year),the FEV 1,PaO 2,PaO 2,6MWD were significantly increased( P <0 01);the evaluation grade of r espiratory difficulty was decreased( P <0 01);the score of social intercou rse was significantly increased( P <0 01);However the score of HRSD and HA MA was not changed significantly( P >0 05).Conclusions:LTDOT can maintain t he PaO 2 in high level on COPD,improve the lung function and the grade of resp iratory difficulty,increased exercise endurance,extend the social activity area and ability so as to improve the life quality.But the improvement of psychologic al status on COPD has not been observed in LTDOT.