社区呼吸支持中心对慢性阻塞性肺疾病稳定期的影响

目的探讨建立社区呼吸支持中心对慢性阻塞性肺疾病（简称慢阻肺）稳定期的影响。方法选择64例55岁以上慢阻肺稳定期且GOLD分级Ⅲ级的患者,随机分为两组,呼吸支持组接受社区呼吸支持中心治疗,包括健康教育、长期氧疗（LTOT）、长期雾化吸入氨溴索、长期使用布地奈德福莫特罗粉吸入剂。对照组入选时给予患者处方布地奈德福莫特罗粉吸入剂,同时告知对照组患者需要在家进行LTOT和长期雾化吸入氨溴索,嘱每月门诊随访。结果呼吸支持组治疗24个月后SpO2、PaO2、FEV1%pred、6MWD、BMI、ALB上升,mMRC、CAT、Hb、PaCO2下降（P〈0.05）;对照组FEV1%pred下降,mMRC、CAT上升（P〈0.05）,余指标未见改变（P〉0.05）;呼吸支持组急性加重次数、住院次数比对照组少（P〈0.05）。结论社区呼吸支持中心的建立有利于纠正重度COPD稳定期患者的低氧血症,延缓肺功能恶化,改善患者营养状态,同时可以使患者对治疗的依从性增加。

The Influence of Community Respiratory Support Center on Stable Chronic Obstructive Pulmonary Disease

Objective To explore the effect of respiratory support in Community Respiratory Support Center on patients with chronic obstructive pulmonary disease（ COPD） in stable phase. Methods Sixty-four GOLD grade Ⅲ patients with stable COPD over age of 55 years were randomly divided into two groups. A respiratory support group received respiratory support in Community Respiratory Support Center,including health education,long-term oxygen therapy（ LTOT）,long-term ambroxol for atomization,long-term budesonide and formoterol for inhalation. A control group were prescribed budesonide and formoterol for inhalation when recruited,informed LTOT and long-term ambroxol for atomization at home,and follow-up visits to clinic every month. Results After 24 months of treatment in the respiratory support group,SpO2,PaO2,FEV1% pred,6MWD,BMI,and ALB increased,mMRC,CAT,Hb,PaCO2decreased（ P 〈 0. 05）.While in the control group,FEV1% pred decreased,mMRC and CAT increased（ P 〈 0. 05）,other indexes did not change significantly（ P 〉 0. 05）. The times of acute exacerbation and hospitalization of the respiratory support group was less than that in the control group（ P 〈 0. 05）. Conclusions Establishing Community Respiratory Support Center will benefit patients with stable COPD correct hypoxemia,slow the deterioration of lung function,improve the nutritional status of patients,and can also increase patients compliance to treatment.