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題名 | Effects of Domiciliary Nocturnal Ventilatory Support in Patients with Chronic Respiratory Failure=慢性呼吸衰竭病患居家夜間通氣支持的成效 |
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作者 | 江玲玲; 吳英黛; 王儷穎; 林鴻銓; 李俊年; | 書刊名 | 胸腔醫學 |
卷期 | 19:1 2004.02[民93.02] |
頁次 | 頁10-17 |
分類號 | 415.41 |
關鍵詞 | 慢性呼吸衰竭病患; 居家夜間通氣支持; 六分鐘行走測試; 動脈血氣體分析值; Chronic respiratory failure; Domiciliary nocturnal ventilation support; 6-minute walking test; Arterial blood gas; |
語文 | 英文(English) |
中文摘要 | 研究背景:居家夜間通氣支持常運用於治療慢性呼吸衰竭的病患,然而有控制組的隨機分配之研究相當少。 目的:本研究探討慢性呼吸衰竭病患使用六個月夜間通氣支持後,在動脈血氧氣體分析值、運動耐力與再度住院方面的改變和成效。 方法:住院之慢性呼吸衰竭病患隨機分配至治療組和控制組,共計29位(13位夜間通氣支持組及16位控制組)完成本研究。夜間通氣支持組中11位使用雙期正壓通氣方式(Respironics),2位使用攜帶型容積控制之呼吸器(PLV 100)。受試者在出院前及居家治療六個月後各作一動脈血氣體分析測量和六分鐘行走測試,並記錄病患此次住院之前六個月及參與本研究六個月期間的住院次數及住院天數。 結果:居家夜間通氣支持組之動脈血二氧化碳分壓、重碳酸離子及鹼超出量皆較治療前減少,六分鐘行走距離由281.2±104.6米增至381.9±87.4米,均較控制組明顯改善,且治療組之住院次數及天數亦明顯較控制組減少。 結果:給予慢性呼吸衰竭病患居家夜間通氣支持治療六個月,可以改善動脈血氣體分析植、增進運動耐力,並減少住院次數及天數,未來宜進一步探討對病患生活品質與醫療費用的成效。 |
英文摘要 | Background: Domiciliary noctumal ventilatory support (DNVS) is often used to treat patients with chronic respiratory failure, however, few randomized, controlled studies have investigated its efficacy. Alms: The purpose of this study was to investigate the effects of a 6-month DNVS intervention on arterial blood gases, exercise capacity, and rate of hospital admissions of in patients with chronic respiratory failure. Methods: Twenty-nine inpatients with chronic respiratory failure were randomly allocated to either the DNVS (n=13) or the control group (n=16). Among the patients in the DNVS group, 11 received ventilatory support from Bbilevel positive airway pressure (BiPAP) (Respironics), and 2 received portable volume ventilatory support (PVL 100) for 6 months. All patients were followed once a month for 6 months after discharge from the hospital. Arterial blood gases and exercise capacity were measured at discharge and 6 months after discharge. Exercise capacity was assessed by a standardized six-minute walking test (6MWT). The number of hospital admissions and length of stay for the 6-month period before enrollment and during the 6-month study period were determined from chart records. Results: Subjects in the DNVS group showed significant reductions in PaCO2, HCO3-, and BE compared to the levels before intervention and also compared to the control group. The Six-minute walking distance (6MWD) also increased significantly in the DNVS group, from 281.2±104.6 m before intervention to 381.9±87.4 m after intervention (p<0.001), and significant differences between the groups were found. Moreover, the DNVS group had significantly fewer admissions and days of stay in the hospital during the intervention period compared to before the 6-month intervention and to the control group. Conclusions: Six-month DNVS intervention improved arterial blood gases, increased exercise capacity, and reduced the number of hospital admissions and length of stay in patients with chronic respiratory failure. Further studies to address the effects of DNVS on quality of life and health cost should be encouraged. |
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