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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。
Objective To explore the influence of establishing community respiratory support center on the stable phase of chronic obstructive pulmonary disease (COPD). Methods Sixty-four patients with stable chronic obstructive pulmonary disease (COPD) over the age of 55 with GOLD grade Ⅲ were randomly divided into two groups. The respiratory support group received community respiratory support center, including health education, long-term oxygen therapy (LTOT) Inhaled ambroxol, long-term use of budesonide formoterol powder inhaler. Patients in the control group were given budesonide formoterol powder for inhalation at the time of enrollment, while patients in the control group were required to have LTOT and long-term inhalation of ambroxol at home and were instructed to follow the monthly outpatient visits. Results The levels of SpO2, PaO2, FEV1% pred, 6MWD, BMI, ALB increased, while the levels of mMRC, CAT, Hb and PaCO2 decreased in the respiratory support group (P <0.05) P <0.05). No changes were found in the remaining indexes (P> 0.05). The number of exacerbations and hospitalizations in the respiratory support group was less than that in the control group (P <0.05). Conclusion The establishment of Community Respiratory Support Center is conducive to the correction of hypoxemia in stable COPD patients, slowing the deterioration of lung function, improving the nutritional status of patients and increasing the patients’ compliance with the treatment.