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題名 | The Role of Noninvasive Positive Pressure Ventilation in Hypoxemic Respiratory Failure--A Review of the Literature=非侵襲性陽壓呼吸輔助於缺氧性呼吸衰竭之運用 |
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作者 | 葉育雯; 高尚志; Yeh, Yu-wung; Kao, Shang-jyh; |
期刊 | 胸腔醫學 |
出版日期 | 20020600 |
卷期 | 17:2 2002.06[民91.06] |
頁次 | 頁106-113 |
分類號 | 415.3 |
語文 | eng |
關鍵詞 | 非侵襲性陽壓呼吸輔助; 呼吸衰竭; 缺氧; |
中文摘要 | 非侵襲性陽壓呼吸輔助(NPPV)有許多理論上的益處,包括避免氣管內插入所引起之併發症、增進病患的舒適度、保留呼吸道天然的保衛機轉、說話能力、以及吞嚥能力。自1935年起便有報告提出持續性陽壓呼吸輔助(CPAP)於肺水腫之病患治療之益助。在1970年代更有持續性陽壓以及間歇性陽壓呼吸輔助(IPPV)運用於缺氧性呼吸衰竭及以神經肌肉性及慢性阻塞性肺病之報告出爐。在1980年代開始有較大型隨機試驗探討非侵襲性陽壓呼吸輔助在高二氧化碳以及缺氧性呼吸衰竭之運用。以目前已出版之報告來評估,非侵襲性陽壓呼吸輔助在高二氧化碳性呼吸衰竭病患之治療有一定的助益。在缺氧性呼吸衰竭之治療上,由於人數較少,可參考資較不齊全。自1990年起,才陸續有著重於缺氧性呼吸衰竭與非侵襲性陽壓呼吸輔助之研究。研究證明,非侵襲性陽壓呼吸輔助再缺氧性呼吸衰竭的治療上亦佔了一席之地。 |
英文摘要 | Nonivasive positive pressure ventilation (NIPPV) was first adopted in the 1930's for use on patients with respiratory failure. It did not gain popularity until the 1980's when a number of small reports came out in favor of its use in primarily hypercapnic failure and post-extubation patients. Its benefit in hypoxemic respiratory failure is still controversial. We reviewed randomized trials published since 1995 on the use of NIPPV in patients with hypoxemic respiratory failure. Of the eight randomized trails published since 1995, six reported a significant decrease in the endotracheal intubation (ETI) rate with NIPPV use.However, one of the six trials had a large proportion of COPD patients and did not show a decrease in the ETI rate when the COPD patients were excluded from the analysis. Of the two that did not show a decreases in the ETI rate, one had a small sample size, and the other was done on emergency room patients. Two of the eight studies also reported a decrease in the mortality rate. In conclusion, NIPPV is probably helpful in patients with hypoxemic respiratory failure as well, but not to such a marked extent as with hypercapnic respiratory failure. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。