摘 要
慢性阻塞性肺疾病（COPD）是全球范围内导致死亡和残疾的主要原因之一。长期氧疗（LTOT）被认为是改善COPD患者生存率和生活质量的有效手段，但其依从性问题一直是临床实践中的挑战。本研究旨在探讨影响COPD患者LTOT依从性的因素，并提出相应的干预策略。研究采用横断面调查和纵向追踪相结合的方法，选取了2019年至2021年间在中国某大型综合医院接受LTOT的150名COPD患者作为研究对象。通过问卷调查、医学记录回顾和半结构化访谈，收集了患者的基线特征、治疗依从性数据及生活质量指标。结果显示，患者的年龄、教育水平、经济状况以及对LTOT的认知程度显著影响其依从性。具体而言，年轻患者和高教育水平患者表现出更高的依从性，而经济困难和对LTOT益处的不了解则是降低依从性的主要障碍。此外，研究发现家庭支持和社会医疗服务的可及性对提高LTOT依从性具有积极作用。基于这些发现，本研究提出了包括加强患者教育、提供经济援助和增强社会支持在内的多维度干预措施。这些措施在初步试点中显示出显著效果，提高了患者的LTOT依从率和整体生活质量。
关键词：慢性阻塞性肺疾病;长期氧疗;依从性
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death and disability worldwide. Long-term oxygen therapy (LTOT) is considered an effective means to improve the survival rate and quality of life in patients with COPD, but its compliance problem has been a challenge in clinical practice. This study aimed to explore the factors affecting LTOT adherence in COPD patients and propose corresponding intervention strategies. Using a combination of cross-sectional survey and longitudinal tracing, 150 COPD patients undergoing LTOT at a large general hospital in China between 2019 and 2021 were selected. Baseline characteristics, treatment adherence data and quality of life indicators were collected through questionnaires, medical record review and semi-structured interviews. The results showed that their age, education level, financial status, and perception of LTOT significantly influenced their compliance. Specifically, younger patients and those with higher education levels showed higher adherence, while financial difficulties and ignorance of the benefits of LTOT are major barriers to reduced adherence. Furthermore, family support and accessibility of social medical services were found to have a positive effect on improving LTOT adherence. Based on these findings, this study proposes multi-dimensional interventions including enhanced patient education, provided financial assistance, and enhanced social support. These measures showed significant effects in the initial pilot, improving patient LTOT adherence rates and overall quality of life.
Keywords：Chronic obstructive pulmonary disease; long-term oxygen therapy; compliance
目 录
引 言 1
第一章 慢性阻塞性肺疾病概述 2
1.1 慢性阻塞性肺疾病的定义与分类 2
1.2 慢性阻塞性肺疾病的流行病学特征 2
1.3 慢性阻塞性肺疾病的主要症状与诊断标准 3
第二章 长期氧疗的必要性与机制 4
2.1 长期氧疗在慢性阻塞性肺疾病治疗中的地位 4
2.2 长期氧疗的生理学基础 4
2.3 长期氧疗对患者生活质量的影响 5
第三章 患者依从性的影响因素分析 6
3.1 患者个体特征对依从性的影响 6
3.2 社会经济因素对依从性的影响 6
3.3 医疗系统支持对依从性的影响 7
3.4 心理因素对依从性的影响 7
第四章 提高依从性的策略与实践研究 9
4.1 基于患者教育的依从性提升策略 9
4.2 家庭支持在提高依从性中的作用 9
4.3 医疗团队的角色与干预措施 10
4.4 政策与社区资源的整合利用 10
结 论 12
参考文献 13
致 谢 14
慢性阻塞性肺疾病（COPD）是全球范围内导致死亡和残疾的主要原因之一。长期氧疗（LTOT）被认为是改善COPD患者生存率和生活质量的有效手段，但其依从性问题一直是临床实践中的挑战。本研究旨在探讨影响COPD患者LTOT依从性的因素，并提出相应的干预策略。研究采用横断面调查和纵向追踪相结合的方法，选取了2019年至2021年间在中国某大型综合医院接受LTOT的150名COPD患者作为研究对象。通过问卷调查、医学记录回顾和半结构化访谈，收集了患者的基线特征、治疗依从性数据及生活质量指标。结果显示，患者的年龄、教育水平、经济状况以及对LTOT的认知程度显著影响其依从性。具体而言，年轻患者和高教育水平患者表现出更高的依从性，而经济困难和对LTOT益处的不了解则是降低依从性的主要障碍。此外，研究发现家庭支持和社会医疗服务的可及性对提高LTOT依从性具有积极作用。基于这些发现，本研究提出了包括加强患者教育、提供经济援助和增强社会支持在内的多维度干预措施。这些措施在初步试点中显示出显著效果，提高了患者的LTOT依从率和整体生活质量。
关键词：慢性阻塞性肺疾病;长期氧疗;依从性
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death and disability worldwide. Long-term oxygen therapy (LTOT) is considered an effective means to improve the survival rate and quality of life in patients with COPD, but its compliance problem has been a challenge in clinical practice. This study aimed to explore the factors affecting LTOT adherence in COPD patients and propose corresponding intervention strategies. Using a combination of cross-sectional survey and longitudinal tracing, 150 COPD patients undergoing LTOT at a large general hospital in China between 2019 and 2021 were selected. Baseline characteristics, treatment adherence data and quality of life indicators were collected through questionnaires, medical record review and semi-structured interviews. The results showed that their age, education level, financial status, and perception of LTOT significantly influenced their compliance. Specifically, younger patients and those with higher education levels showed higher adherence, while financial difficulties and ignorance of the benefits of LTOT are major barriers to reduced adherence. Furthermore, family support and accessibility of social medical services were found to have a positive effect on improving LTOT adherence. Based on these findings, this study proposes multi-dimensional interventions including enhanced patient education, provided financial assistance, and enhanced social support. These measures showed significant effects in the initial pilot, improving patient LTOT adherence rates and overall quality of life.
Keywords：Chronic obstructive pulmonary disease; long-term oxygen therapy; compliance
目 录
引 言 1
第一章 慢性阻塞性肺疾病概述 2
1.1 慢性阻塞性肺疾病的定义与分类 2
1.2 慢性阻塞性肺疾病的流行病学特征 2
1.3 慢性阻塞性肺疾病的主要症状与诊断标准 3
第二章 长期氧疗的必要性与机制 4
2.1 长期氧疗在慢性阻塞性肺疾病治疗中的地位 4
2.2 长期氧疗的生理学基础 4
2.3 长期氧疗对患者生活质量的影响 5
第三章 患者依从性的影响因素分析 6
3.1 患者个体特征对依从性的影响 6
3.2 社会经济因素对依从性的影响 6
3.3 医疗系统支持对依从性的影响 7
3.4 心理因素对依从性的影响 7
第四章 提高依从性的策略与实践研究 9
4.1 基于患者教育的依从性提升策略 9
4.2 家庭支持在提高依从性中的作用 9
4.3 医疗团队的角色与干预措施 10
4.4 政策与社区资源的整合利用 10
结 论 12
参考文献 13
致 谢 14
