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相關文獻
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頁籤選單縮合
題名 | 非侵襲性呼吸器--神經肌肉病變患者之另一種選擇=Non-Invasive Respirator--An Alternative in Patients with Neuromuscular Disease |
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作者 | 王亭貴; 洪榮斌; 鄭美麗; 賴金鑫; 連倚南; Wang, Tyng-guey; Hong, Rong-bin; Cheng, Mei-li; Lai, Jin-shin; Lien, I-nan; |
期刊 | 復健醫學會雜誌 |
出版日期 | 19970600 |
卷期 | 25:1 1997.06[民86.06] |
頁次 | 頁33-39 |
分類號 | 415.415 |
語文 | chi |
關鍵詞 | 非侵襲性呼吸器; 神經肌肉病變; 呼吸衰竭; Non-invasive respirator; Neuromuscular disease; Rspiratory failure; Life quality; |
中文摘要 | 本研究是描述過去三年中,臺大醫院復健部於神經肌肉病變患者使用非侵襲性呼 吸器的臨床經驗,討論這類呼吸器的效果,優缺點及適應症,以供須照顧這群病患之同僚參 考。 在 15 名接受非侵襲性呼吸的患者中,有 2 名患者沒有成功。其餘 13 名病人平均使 用了 13.5 ± 11.8 個月。 有 3 名患者後來也終止使用,其一為車禍死亡,2 名為肺部分 泌物無法排除而須接受氣管造口。 患者平均在肺活量為預測值之 38.5 ± 15% 時,必須接 受非侵襲性呼吸器。有 10 名患者因呼吸衰竭,4 名因夜眠呼吸異常,1 名因呼吸急促而須 接受此類呼吸器。8 名因呼吸衰竭而接受呼吸器的患者於使用呼吸器後,其血中二氧化碳分 壓由 74.0 ± 18.2mmHg 降至 45.7 ± 55.2mmHg 而血氧分壓由 67.2 ± 10.2 mmHg 昇至 90.7 ± 9.3 mmHg。 在 13 名長期使用非侵襲性呼吸器的患者,有 5 名可回去上學或工作 ,3 名退休但仍有社交生活,4 名須臥床,1 名則留置醫院。使用時,少數患者抱怨無法排 除肺部分泌物、鼻塞、腹脹或臉部壓痕,但都不需中止使用此類呼吸器。我們認為對於神經 肌肉病變患者,若適當的使用非侵襲性呼吸器,可治療其呼吸衰竭,減少肺合併症,並維持 生活品質。 |
英文摘要 | Fifteen individuals with neuromuscular disease and ventilatory insufficiency received noninvasive respirator(NIR) for their respiratory failure, severe sleep disordered breathing, or respiratory distress. By providing the NIR, thirteen patients successfully maintained their ventilation for a mean duration of 13.5± 11.8 months (range: 2 to 36), ten of them still used NIR effectively at the time of report. The four patients failed in using NIR were all motor neuron disease. The reason for discontinuing NiR was difficulty in handling pulmonary secretions. After inducing NIR, the blood gas of our patients returned to normal limit (PaO �� 67.2 ± 10.2 mmHg elevated to 90.7 ± 9.3 mmHg and PaCO �� from 74.0 ± 18.2 mmHg decreased to 45.7 ± 5.2 mmHg). At the time of using NIR, three patients could return to school; two resumed their work, and three retired but kept regular social life. Only one patient must stayed in the hospital because of deterioration in respiratory function, and four patients became bed-ridden by their miserable limb weakness. All patients with NIR could communicate and feed by oral. No major complications occurred during the period of using NIR, except that four patients had profound sputum; one had pneumothorax; one was bothered by nasal obstruction; one had flatus, and three had nasal ridge skin ulcer. All the problems were relieved by conservative method without the necessity of discontinuing NIR. We believed that NIR was an alternative management with satisfactory efficiency and limited pitfalls for individuals with neuronmuscular disease and respiratory insufficiency. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。