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Published on: October 11, 2011
在严重的低氧症中,每天24小时或15小时的长期氧气治疗
Magnus Ekström1, Anders Andersson1, Savvas Papadopoulos1
1From Respiratory Medicine, Allergology, and Palliative Medicine, Department of Clinical Sciences in Lund, Faculty of Medicine, Lund University, Lund (M.E., F.B.), the Department of Medicine, Blekinge Hospital, Karlskrona (M.E.), the COPD Center, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg (A.A.), and the Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital (S.P.), Gothenburg, Karlstad County Hospital, Karlstad (T.K.), Northern Älvsborg County Hospital, Trollhättan (B.P.), Linköping University Hospital, Linköping (O.K.), Falun Hospital, Falun (P.S.), the Department of Respiratory Medicine and Allergology, Faculty of Medicine, Karolinska University Hospital (M.R.), and Karolinska University Hospital Huddinge (R.H.), Stockholm, the Department of Medical Sciences, Respiratory, Allergy, and Sleep Research, Uppsala University (A.P., E.L., C.J.), and the Uppsala Clinical Research Center (N.H.), Uppsala, the Center for Research and Development, Gävle Hospital, Gävle (A.P.), the Department of Public Health and Clinical Medicine, Umeå University, Umeå (A.B.), Sundsvall-Härnösand County Hospital, Sundsvall (B.S.), and the Department of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro (J.S.) - all in Sweden; the Institute for Breathing and Sleep and the Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, VIC (C.F.M.), and the Graduate School of Medicine, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, NSW (D.C.C.) - both in Australia.
长期氧气治疗严重的低氧症每天24小时不超过每天15小时. 这项研究发现,在两种氧气疗法持续时间之间的一年内,住院或死亡风险没有显著差异.
科学领域:
- 肺部医学 肺部医学
- 临界护理医学 临界护理医学
- 临床试验 临床试验
背景情况:
- 长期氧气治疗 (LTOT) 是为严重的低氧症而建立的,延长了生存时间.
- 目前的建议建议LTOT至少每天15小时.
- 一天24小时的治疗方案更繁重,其在每天15小时以上的益处没有得到证实.
研究的目的:
- 为了测试24小时/天的LTOT是否会降低住院或死亡风险,与15小时/天的LTOT相比,1年后.
- 评估慢性严重低氧症患者每天15小时LTOT的非劣势性.
主要方法:
- 进行了一项基于注册的多中心随机对照试验.
- 241名患有慢性严重低氧症的患者随机分配到24小时/天或15小时/天的LTOT.
- 主要结局是住院或1年内死亡的组合.
主要成果:
- 在24小时和15小时LTOT组 (HR,0.99;95% CI,0.72-1.36) 之间没有观察到1年内住院或死亡风险的显著差异.
- 每100个人年平均事件率相似:24小时为124.7,15小时为124.5 LTOT.
- 在初级结果或组间不良事件的单个组件中没有发现实质性的差异.
结论:
- 对于患有严重低氧症的患者,24小时/天的LTOT与15小时/天的LTOT相比,在1年内住院或死亡风险方面没有显著的优势.
- 研究结果表明,对于这种患者群体来说,更轻松的每天15小时的治疗方案可能足够.
- 这项研究提供了证据,以潜在地优化LTOT协议,平衡有效性与患者的坚持和生活质量.
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