摘要目的 评价长期家庭氧疗结合肺脏康复训练对慢性阻塞性肺疾病(COPD)患者临床疗效的影响.方法 72例需接受长期家庭氧疗的COPD患者按随机数字表法随机分为治疗组和对照组各36例.对照组予常规长期家庭氧疗治疗,治疗组同时进行肺脏康复训练.2年后比较肺功能、动脉血气参数和血液流变学指标；记录病情变化情况.结果 两组随访1～2年,治疗组平均急性加重次数为(3.0±1.3)次,低于对照组的(4.0±1.6)次,差异有统计学意义(t=1.893,P＜0.05).治疗组治疗2年与对照组相比,1秒钟用力呼气量(FEV1)[(1.59±0.08)L与(1.41 ±0.13)L,t=- 3.966,P＜0.01]、用力肺活量(FVC)[ (2.47±0.20)L与(2.27 ±0.17)L,t=-2.788,P＜0.05]、FEV1占预计值百分比(FEV1％)[(62.1±6.2)％与(53.1±5.0)％,t=-4.402,P＜0.01]和动脉血氧分压(Pa02)[(79.1±8.9)kPa与(60.0±6.6) kPa,t=-4.622,P＜0.01]显著升高；血浆黏度[(2.14±0.31)mPa·s与(2.44±0.45) mPa·s,t=1.985,P＜0.05]、全血低切黏度[(13.48±1.97)mPa·s与(14.33±1.87)mPa·s,t=2.126,P＜0.05]、全血中切黏度[(6.33±0.66)mPa·s与(7.92±0.98)mPa·s,t=4.238,P＜0.01]、全血高切黏度[(4.58±0.59)mPa·s与(5.33±0.68)mPa·s,t=3.890,P＜0.01]和红细胞沉降率[ (30.63±5.76) mm/1 h与(35.63±6.93) mm/1 h,t=2.230,P＜0.05]显著降低.结论 长期家庭氧疗结合肺脏康复训练可明显改善COPD患者肺功能、动脉血气参数和血液流变学状况.

abstractsObjective To evaluate the clinical effects of long-term domiciliary oxygen therapy (LDOT)in accompany with pummonary rehabilization program on the patients with chronic obstructive pulmonary disease (COPD).Methods Seventy two COPD cases receiving LDOT treatment were randomized into treatment group and control group.The patients in control group were given LDOT alone,while the treatment group was given pulmonary rehabilization besides LDOT.Lung functions,arterial blood gas parameters and blood rheological parameters were compared between the two groups 2 years after the observation.Results The follow-up period lasted for 1 - 2 years.The frequency of acute exageration in the treatment group ( 3.0 ± 1.3 ) was significantly lower than that of control group (4.0 ± 1.6) ( t =1.893,P ＜ 0.05 ).Compared with that of control group,the FEV1([1.59±0.08]L vs.[1.41 ±0.13]L,t =-3.966,P ＜0.01),FVC ([2.47 ±0.20]L vs.[2.27 ±0.17]L,t=-2.788,P＜0.05),FEV1％ ([2.47±0.20]％ vs.[2.27±0.17]L,t=-4.402,P＜0.01) and PaO2 ( [79.1 ± 8.9 ] kPa vs.[ 60.0 ± 6.6 ] kPa,t =- 4.622,P ＜ 0.01 ) were significantly increased,while plasma viscosity ( [ 2.14 ± 0.31] mPa · s vs.[ 2.44 ± 0.45 ] mPa · s,t =1.985,P ＜ 0.05 ),Low shear blood viscosity ( [ 13.48 ± 1.97 ] mPa · s vs.[ 14.33 ± 1.87 ] mPa · s,t =2.126,P ＜ 0.05 ),median shear whole blood viscosity( [ 6.33 ± 0.66 ] mPa · s vs.(7.92 ± 0.98 ) mPa · s,t =4.238,P ＜ 0.01 ),high shear whole blood viscosity ([4.58 ±0.59] mPa · s vs.[5.33 ±0.68]mPa · s,t =0.3890,P ＜0.01) and erythrocyte sedimentation rate ( [ 30.63 ± 5.76 ] mm/1 h vs.[ 35.63 ± 6.925 ] mm/1 h,t =2.230,P ＜ 0.05 ) was greatly decrease.Conclusion Long-term domiciliary oxygen therapy in company with pulmonary rehabilization program is helpful to improve the lung function,arterial blood gas parameters and rheological status of COPD patients.