睡眠呼吸监测结合肺功能、动脉血气分析对慢性缺氧性疾病家庭氧疗的评估意义

Significance of polysomnography monitoring combined with pulmonary function and arterial blood gas analysis for long-term oxygen therapy in chronic hypoxic disease

摘要:

目的 探讨睡眠呼吸监测结合肺功能、动脉血气分析对慢性缺氧性疾病长期家庭氧疗（LTOT）的评估意义。方法 选取2016年6月—2017年6月蚌埠市第二人民医院诊断为慢性阻塞性肺疾病（COPD）稳定期患者共120例，随机将其分为对照组和观察组，每组60例。对照组采用常规药物治疗，观察组结合LTOT，每日 吸氧至少15?h，2?L/min。分别于治疗前、治疗后1、3和6个月，采用多导睡眠监测（PSG）仪监测夜间氧饱和度 低于90%的时间占总睡眠时间的百分比（SIT90）和睡眠呼吸暂停低通气指数（AHI），肺功能检测第1秒用力呼气 容积/用力肺活量（FEV1%）和FEV1%预计值，动脉血气分析动脉血二氧化碳分压（PaCO2）和动脉血氧分压（PaO2）。结果 对照组与观察组治疗前、治疗后1、3和6个月的SIT90、AHI、FEV1%、FEV1%预计值、PaCO2及PaO2比较：①不同时间点的SIT90、AHI、FEV1%、FEV1%预计值、PaCO2及PaO2有差异（P?<0.05）；②两组的SIT90、AHI、FEV1/FVC、FEV1%预计值、PaCO2和PaO2有差异（P?<0.05），治疗后观察组SIT90、AHI及PaCO2较低，FEV1%、FEV1%预计值及PaO2较高；③两组的SIT90、AHI、FEV1%、FEV1%预计值、PaCO2及PaO2变化趋势有差异（P?<0.05）。结论 LTOT对改善COPD稳定期患者的夜间缺氧、肺功能及动脉血气均有较好的应用价值。

Abstract:

Objective To study values of polysomnography monitoring (PSG) combined with pulmonary function and arterial blood gas analysis for long-term oxygen therapy (LTOT) in chronic hypoxic disease. Methods A total of 120 subjects as chronic obstructive pulmonary disease (COPD) of stable period from June 2016 to June 2017 were enrolled and divided randomly into control and observation groups, each of 60 cases; patients in control group received common drug treatment and patients in observation group adopted common treatment combined with LTOT, at least 15?h oxygen inhalation per day, 2?L/min; then to compare differences of hour ratio of nocturnal oxygen saturation < 90% time to total sleep time (SIT90) and apnea hypopnea index (AHI), FEV1% and FEV1% predicted value, PaCO2 and PaO2 were measured by PSG before treatment, one, three and six months after treatment. Results The SIT90, AHI, FEV1/FVC, FEV1 real/pre, PaCO2 and PaO2 of the control group were compared with those of the observation group before treatment, 1 month, 3 months and 6 months after treatment. The results of variance analysis of repeated measurement data were as follows:① SIT90, AHI, FEV1%, FEV1% pre, PaCO2 and PaCO2 at different time points were all different (P?