Kao Tze-Wah, Huang Kuo-Chiang, Huang Yu-Ling, Tsai Tun-Jun, Hsieh Bor-Shen, Wu Ming-Shiou
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2004 Aug;103(8):624-8.
Most patients with end-stage renal disease (ERSD) visiting our hospital for hemodialysis treatment during the SARS outbreak wore an N95 mask. Data on the physiological stress imposed by the wearing of N95 masks remains limited. This study investigated the physiological impact of wearing an N95 mask during hemodialysis (HD) on patients with ESRD.
ESRD patients who received regular HD at National Taiwan University Hospital between April to June 2003 were enrolled. Each patient wore a new N95 mask (3M Model 8210) during HD (4 hours). Vital signs, clinical symptoms and arterial blood gas measured before and at the end of HD were compared.
Thirty nine patients (23 men; mean age, 57.2 years) were recruited for participation in the study. Seventy percent of the patients showed a reduction in partial pressure of oxygen (PaO2), and 19% developed various degrees of hypoxemia. Wearing an N95 mask significantly reduced the PaO2 level (101.7 +/- 12.6 to 92.7 +/- 15.8 mm Hg, p = 0.006), increased the respiratory rate (16.8 +/- 2.8 to 18.8 +/- 2.7/min, p < 0.001), and increased the occurrence of chest discomfort (3 to 11 patients, p = 0.014) and respiratory distress (1 to 17 patients, p < 0.001). Baseline PaO2 level was the only significant predictor of the magnitude of PaO2 reduction (p < 0.001).
Wearing an N95 mask for 4 hours during HD significantly reduced PaO2 and increased respiratory adverse effects in ESRD patients.
在严重急性呼吸综合征（SARS）疫情期间，大多数到我院进行血液透析治疗的终末期肾病（ERSD）患者佩戴了N95口罩。关于佩戴N95口罩所带来的生理应激的数据仍然有限。本研究调查了终末期肾病患者在血液透析（HD）期间佩戴N95口罩的生理影响。
纳入2003年4月至6月在台湾大学附属医院接受常规血液透析的终末期肾病患者。每位患者在血液透析期间（4小时）佩戴一个新的N95口罩（3M 8210型）。比较血液透析开始前和结束时测量的生命体征、临床症状和动脉血气。
招募了39名患者（23名男性；平均年龄57.2岁）参与本研究。70%的患者氧分压（PaO2）降低，19%出现不同程度的低氧血症。佩戴N95口罩显著降低了PaO2水平（从101.7±12.6降至92.7±15.8 mmHg，p=0.006），增加了呼吸频率（从16.8±2.8增至18.8±2.7次/分钟，p<0.001），并增加了胸部不适（从3例增至11例，p=0.014）和呼吸窘迫（从1例增至17例，p<0.001）的发生率。基线PaO2水平是PaO2降低幅度的唯一显著预测因素（p<0.001）。
在血液透析期间佩戴N95口罩4小时会显著降低终末期肾病患者的PaO2并增加呼吸不良反应。
