氧氣輔助慢性阻塞性肺部疾病患者運動訓練及行走時之成效

The Efficacy of Oxygen Adjuncts to Exercise Training and Ambulation for Patients with Chronic Obstructive Pulmonary Disease

李俊年(Chun-Nin Lee) ； 陳曉宜(Shiau-Yee Chen) ； 蘇千玲(Chien-Ling Su) ； 黃卓禕(Cho-Yi Huang) ； 許翰琳(Han-Lin Hsu) ； 江玲玲(Ling-Ling Chiang)

《呼吸治療》 9卷1期 (2010/01) Pp. 63-73

https://doi.org/10.6269/JRT.2010.9.1.07

摘要

慢性阻塞性肺部疾病患者的骨骼肌功能不全，在四肢肌力及耐力型運動比呼吸肌訓練更爲必要，因其能延緩運動性酸血症，減少呼吸作功。肢體運動訓練之生理成效已被證實，但對全身發炎指標及運動誘發氧化壓力因素仍需再深入研究。
行走中氧氣輔助之立即成效爲氧氣能增進耐力型運動測試(endurance exercise test)時之運動量（如行走距離、或階梯數），且能改善耐力型運動測試時同一時間點之柏格喘氣指數、SaO2/PaO2及通氣量。此觀念可應用於評估行走中提供氧氣之適應症及適當氧氣劑量方法。
過去研究強力推薦長期持續氧氣治療應用於慢性阻塞性肺部疾病患者合併嚴重低血氧症，不管休息或運動皆是必要的。然而綜合分析研究結果仍無足夠研究支持以下臨床作法，因此列爲中度推薦之建議，如下：在非長期氧氣治療適應症者藉由行走測試評估，若出現運動誘發低血氧，應於運動或居家活動時使用氧氣。但即使評估時沒有出現運動誘發低血氧，於運動或居家活動時使用氧氣仍可增加運動訓練劑量，以達到有效運動訓練成效。

關鍵字

行走中攜帶氧氣 ； 運動訓練 ； 居家長期氧氣治療

並列摘要

Most patients with chronic obstructive pulmonary diseases (COPD) have musculoskeletal dysfunction. Due to the trainings of skeletal muscles of extremities and endurance exercise can retard the exercise acidemia and reduce respiratory work it is more necessary than training respiratory muscles. The efficacy of physiology in musculoskeletal training had been proved but we still need future research and study for the systemic inflammatory response and exercise induced oxidation.
Ambulatory oxygen therapy not only could improve endurance exercise test and exercise tolerance (such as walking distance or step test) but also could improve Borg scale, SaO2/PaO2 and ventilation during exercise test. This concept can be applied to assess the indication of ambulatory oxygen therapy and the dosage of oxygen use.
Long term continuous oxygen therapy for patients with COPD complicated with severe hypoxemia is indicated either at rest or during exercise. However there was no enough research data to support the following practice, thus we moderately suggested those concepts as following: in walking test with those COPD patients who are not indicated for long term continuous oxygen therapy, if hypoxemia was induced observed during exercise test, oxygen should be used during exercise training or domiciliary activity; if hypoxemia was not observed, supplemental oxygen still was needed during exercise training or activity for elevating exercise training dosing.

並列關鍵字

ambulatory oxygen ； exercise training ； domiciliary long-term oxygen