Длительная кислородотерапия при хронической дыхательной недостаточности

Хроническая дыхательная недостаточность (ХДН) является ведущей причиной летальности пациентов с бронхолегочными заболеваниями. Одним из ключевых методов лечения ХДН является длительная кислородотерапия (ДКТ). Основная цель ДКТ заключается в улучшении качества жизни, повышении физической работоспособности, снижении частоты обострений и летальности пациентов. Рекомендуется применять кислородотерапию не менее 15-16 ч в день, а при отсутствии эффекта увеличить это время до 24 ч. Показания к ДКТ уже долгое время остаются неизменными. Решение вопроса о назначении ДКТ должно основываться на трехкратных результатах газового состава артериальной крови, причем оценка параметров газообмена может быть произведена только после стабилизации состояния (3-4 нед. после обострения). Также стоит учитывать возможность наличия у пациентов гиперкапнии и вероятность усугубления состояния пациента за счет кислород-индуцированной гиперкапнии и респираторного ацидоза. Несмотря на наличие многочисленных исследований, касающихся применения ДКТ, большинство из них было проведено на пациентах с ХОБЛ, что создает необходимость в более глубоком изучении эффективности данного метода у пациентов с другими заболеваниями. Применение длительной кислородотерапии оказывает положительное влияние на качество жизни, физическую работоспособность, частоту обострений, госпитализаций и выживаемость пациентов. Существуют различные способы доставки кислорода, что позволяет использовать ДКТ не только в состоянии покоя, но и при передвижении пациента на большие расстояния. Важно отметить, что помимо назначения ДКТ пациентам необходимо изменить образ жизни, а именно отказаться от курения, и получать адекватную лекарственную терапию основного заболевания.

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