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相關文獻
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頁籤選單縮合
題名 | Factors Associated with High-frequency Oscillatory Ventilation Response in Infants with Respiratory Failure=呼吸衰竭嬰兒以高頻振幅呼吸療法治療療效因素之探討 |
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作者 | 鄒國英; 唐禎瑞; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 39:3 民87.05-06 |
頁次 | 頁166-172+210 |
分類號 | 417.53 |
關鍵詞 | 呼吸衰竭; 高頻振幅呼吸治療; 新生兒持續性肺高壓症; 急性呼吸窘迫症候群; Respiratory failure; High-frequency oscillatory ventilation; Persistent pulmonary hypertension of newborn; Acute respiratory distress syndrome; |
語文 | 英文(English) |
中文摘要 | 為了解罹患呼吸衰竭,且使用傳統呼吸器及藥物治療均無效之嬰兒,使用高頻振 幅呼吸治療時,與其治療效果及預後相關因素,我們進行了一前瞻性之臨床研究。 共有 24 病人(包括 14 位早產兒)在 1 至 127 天大時接受 30 次的高頻振幅呼吸治療。在治療後 6 至 8 小時,57% 之反應良好,20% 沒有改善,另有 23% 在治療後 10 至 24 小時才有進 步;35% 反應良好的病人之後呼吸狀況變壞。 17 次的治療( 57%,10 次屬療效良好者,2 次屬療不好者,5 次屬療效延遲者)在使用高頻振幅呼吸器 4.6 ± 2.5 天後,可逐漸停 止高頻幅呼吸器之使用。 對高頻振幅呼吸療法反應不好或無法順利中止高頻呼吸治療的病人多為肺部疾病較嚴重( oxygenation index 或 mean airway pressure 較高)或是需要其他輔助性治療的病人。早 產兒和罹患新生兒持續性肺高壓症病之治療效果不錯。在使用新療法 6 至 8 小時後之反應 無法預測病人之存活或是否能順利中止高頻呼吸治療。 由此研究之結果,我們得知罹患呼吸衰竭病人在傳統治療無效時,採用高頻振幅吸吸治療是 有效的。肺部疾病很嚴重者或是需要其它輔助性治療的病人,單獨使用高頻振幅呼吸治療時 ,較不會有好的結果。當病人使用高頻振幅呼吸器治療後,呼吸狀態雖然沒有很明顯的進步 ,但也沒變壞時,應繼續使用高頻振幅呼吸器至 24 小時,有些病人稍晚仍會有進步的。 |
英文摘要 | A prospective, clinical study was conducted to investigate the factors associated with the effectiveness and outcome of high-frequency oscillatory ventilation (HFOV) in infants with respiratory failure unresponsive to optimal conventional respiratory and pharmacological therapy. A high-lung volume strategy was used in cases with diffuse lung disease. A total of 30 treatments in 24 patients (including 14 premature infants), aged 1 to 127 days, was included for analysis. By 6 to 8 hours, >20% improvement in oxygenation (good response) was noted in 57% of treatments, < 20% improvement (Poor response) in 20%, 23% showed delayed response 10 to 24 hours after initiation of HFOV. Thirty -five percent of treatments with initial good response deteriorated later because of sever underlying problems or occurrence of ventilatory complications. Seventeen treatments (57%) were weaned successfully to conventional mechanical ventilation (CMV). Poor response was associated with a higher oxygenation index prior to HFOV and a severe underlying problem. Failure to be successfully weaned to CMV was associated with a higher mean airway pressure and a severe underlying condition. Premature infants and infants with the persistent pulmonary hypertension of newborn usually had a good response to HFOV. From results of this study, it is concluded that patients with severe lung disease and a severe underlying problem responded poorly to HFOV. An initial good response did not predict successful weaning. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。