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我科曾对5例慢性呼衰患者进行家庭氧疗,均在不同程度上达到了提高生活质量、延长寿命之目的。现择其资料齐全者1例报告如下。患者,女,60岁,20多年前因左肺慢性纤维空洞型肺结核反复咯血经正规抗痨治疗无效而行左肺全切术。近10年来反复咳嗽、咳痰、气促,1987年2月5日因症状加重而入院,当时诊断为“左肺全切术后、慢支(喘息型)、肺气肿呼衰(Ⅱ型)、肺心病右心衰(Ⅲ°),经抗炎、祛痰、平喘及执续低流量吸氧等处理后症状减轻。考虑在院生活不便而要求出院治疗。当时吸氧下血气分析为pH7.28,PaO_2 6.80kPa,PaCO_2 8.28kPa,HCO_3~-29.40mmol/L,BE1.50mmol/L。但解除氧疗后出现呼吸困难、紫绀,生活不能自理,遂于同年5月份在医务人员指导下行家庭氧疗,症状改善。此后病情渐好转,半年后改为夜间氧疗,并能自理生活。这次因受凉后病情加剧而于1990年11月19日再次入院,经相应处理后症状一度减轻。但终因肺功能严重损害、低氧血症和高碳酸血症不能纠正以及严重感染而于1990年12月5日死亡。一般认为,家庭氧疗可提高血氧分压,从而防止或减轻肺动脉高压、改善右心功能、防止肺
My department had 5 cases of chronic respiratory failure in patients with home oxygen therapy, to varying degrees, to improve the quality of life, to extend the life of the purpose. Now choose the complete data of one case reported as follows. Patients, female, 60 years old, 20 years ago due to left lung chronic fibrous cavitary tuberculosis repeated hemoptysis by the anti-tuberculosis treatment ineffective left lung total resection. Repeated cough, sputum, shortness of breath in the past 10 years, on February 5, 1987 due to increased symptoms and admitted to hospital, was diagnosed as "left lung resection, chronic bronchitis (wheezing), emphysema respiratory failure ), Pulmonary heart disease, right heart failure (Ⅲ °), after anti-inflammatory, expectorant, asthma and continue to carry out low-flow oxygen and other symptoms alleviate the treatment of hospital life in the inconvenience and require discharge. For the pH7.28, PaO_2 6.80kPa, PaCO_2 8.28kPa, HCO_3 ~ -29.40mmol / L, BE1.50mmol / L. However, lifting oxygen therapy after breathing difficulties, cyanosis, life can not take care of themselves, then in May the same year in the medical staff Guide the downstream family oxygen therapy, the symptoms improved after the condition gradually improved, changed to nighttime oxygen therapy six months later, and can take care of themselves this time because of the cold worsened and re-admitted to hospital on November 19, 1990, after the corresponding treatment of symptoms Was relieved at the same time but eventually died on 5 December 1990 due to severe pulmonary function impairment, uncorrected hypoxemia and hypercapnia, and serious infection, and it is generally accepted that home oxygen therapy enhances the partial pressure of oxygen and thus prevents Or reduce pulmonary hypertension, improve right heart function, prevent lung