Department of Rehabilitation Medicine and Rehabilitation, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2011 Nov;52(6):972-6. doi: 10.3349/ymj.2011.52.6.972.
For patients with neuromuscular disease, air stacking, which inflates the lungs to deep volumes, is important for many reasons. However, neuromuscular patients with severe glottic dysfunction or indwelling tracheostomy tubes cannot air stack effectively. For these patients, we developed a device that permits deep lung insufflations substituting for glottic function.
Thirty- seven patients with bulbar-innervated muscle weakness and/or tracheostomies were recruited. Twenty-three had amyotrophic lateral sclerosis, and 14 were tetraplegic patients due to cervical spinal cord injury. An artificial external glottic device (AEGD) was used to permit passive deep lung insufflation. In order to confirm the utility of AEGD, vital capacity, maximum insufflation capacity (MIC), and lung insufflation capacity (LIC) with AEGD (LICA) were measured.
For 30 patients, MICs were initially zero. However, with the use of the AEGD, LICA was measurable for all patients. The mean LICA was 1,622.7±526.8 mL. Although MIC was measurable for the remaining 7 patients without utilizing the AEGD, it was significantly less than LICA, which was 1,084.3±259.9 mL and 1,862.9±248 mL, respectively (p<0.05).
The AEGD permits lung insufflation by providing deeper lung volumes than possible by air stacking.
对于患有神经肌肉疾病的患者，充气到深容量的空气堆叠对于许多原因都很重要。然而，严重声门功能障碍或留置气管造口管的神经肌肉患者无法有效地进行空气堆叠。对于这些患者，我们开发了一种允许通过替代声门功能进行深肺充气的设备。
招募了 37 名患有延髓支配肌肉无力和/或气管造口术的患者。23 名患者患有肌萎缩侧索硬化症，14 名患者因颈脊髓损伤而四肢瘫痪。使用人工外部声门装置（AEGD）来允许被动深肺充气。为了确认 AEGD 的实用性，测量了肺活量、最大充气容量（MIC）和使用 AEGD 的肺充气容量（LICA）。
对于 30 名患者，MIC 最初为零。然而，使用 AEGD，所有患者均可测量 LICA。平均 LICA 为 1622.7±526.8mL。尽管对于未使用 AEGD 的其余 7 名患者可以测量 MIC，但它明显小于 LICA，分别为 1084.3±259.9mL 和 1862.9±248mL（p<0.05）。
AEGD 通过提供比空气堆叠更深的肺容量来允许肺充气。
