論文詳細
敬心・研究ジャーナル第１巻 第２号
慢性閉塞性肺疾患患者の酸素運搬手段の違いが運動耐容能に及ぼす影響について
坂本雄
比嘉和也
井上諒
沖野桃子
要旨
［目的］ 慢性閉塞性肺疾患（Chronic Obstructive Pulmonary Disease：COPD）患者の在宅酸素療法（Home Oxygen Therapy：HOT）の外出用酸素運搬手段の違いが運動耐容能にどのような影響を及ぼすのかを検証する。［方法］COPD急性増悪にて入院しHOT導入に至った２症例と、COPD急性増悪にて入院し労作時の酸素流量を再検討した１症例の計３症例に対し、１日２回の７日間、牽引型とシルバーカー型の酸素運搬手段をランダムに使用し、６分間歩行試験（6MWT）の歩行距離と経皮的酸素飽和度（SpO2）の変化量を比較した。［結果］歩行距離は３症例ともシルバーカー型が延長した。SpO2の変化量は歩行開始時から最大低下時の差を算出し、３症例ともシルバーカー型の変化量が少ない値を示した。 ［考察］シルバーカー型の酸素運搬手段は左右非対称姿勢を改善し、上肢支持による下肢筋の負担軽減と呼吸補助筋の効率性向上、体幹前傾姿勢による高肺気量位での換気効率向上をもたらし、運動耐容能を向上させたと考えた。
The Influence of Different Oxygen Delivery Systems on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease
Sakamoto Takashi
Higa Kazuya
Inoue Ryo
Okino Momoko
Abstract
Objective: This study examined the influence of different types of portable oxygen delivery systems on the exercise tolerance of patients with chronic obstructive pulmonary disease （COPD） who had received home oxygen therapy （HOT） .
Methods: The study subjects comprised three patients: two patients who were hospitalized due to acute COPD aggravation and then switched to HOT, and one patient who was also hospitalized due to acute COPD aggravation and whose oxygen flow rate was re-measured after exertion. The distance walked during the six-minute walk test （6MWT） and the changes in percutaneous oxygen saturation （SpO2） were compared in these patients using two types of oxygen delivery systems （wheeled oxygen carrier and walking frame with oxygen tank carrier）, at random. The measurements were performed twice a day for seven days.
Results: The distance walked was longer in all three patients when using the walking frame with the oxygen tank carrier. With regard to the change in SpO2, the difference between the lowest value and the value obtained when the subjects started walking was calculated. According to the results obtained, the change was not significant in all three subjects when they used the walking frame with an oxygen tank carrier.
Discussion: Use of oxygen delivery systems, such as the walking frame with an oxygen tank carrier, improved the left-right asymmetry posture, supported the upper extremities resulting in a decreased burden on the leg muscles, improved the effectiveness of the accessory respiratory muscles, and enhanced ventilation efficiency at high lung capacity by allowing the trunk to lean forward, which in turn appeared to improve exercise tolerance.