Matsui Shuji, Nakagawa Gen, Takei Satoko, Matsuda Mitsunobu, Takechi Nobuyuki, Wada Keiko, Akahoshi Keiko, Shiiki Toshihide, Funahashi Masuko, Suzuki Yasuyuki
Tokyo Children's Rehabilitation Hospital, Musasimurayama, Tokyo.
No To Hattatsu. 2012 Jul;44(4):284-8.
We investigated the clinical course of 20 children (persons) with severe motor and intellectual disabilities (SMID) who were treated with noninvasive positive pressure ventilation (NPPV) for respiratory insufficiency. NPPV was effective in 10 of 11 patients treated for acute respiratory failure, and in 7 of 9 patients treated for chronic respiratory failure. Twelve patients were treated with NPPV for more than one year. There were no complications associated with NPPV in any of the patients. NPPV improved ventilation impairment soon after ventilation was started, and avoided the need for the endtracheal intubation by adjusting airway management and the choice of mask in all but one of the patients with acute respiratory failure. NPPV in combination with wearing a chin strap was highly effective in patients with open state or upper airway obstruction. Five patients were successfully weaned off the ventilator soon after recovery from acute respiratory failure using NPPV, whereas 5 patients who continued NPPV during the chronic phase after recovery did not experience recurrent episodes of acute respiratory failure. We conclude that NPPV may be an effective treatment for SMID with respiratory insufficiency.
我们对20名患有严重运动和智力残疾（SMID）且因呼吸功能不全接受无创正压通气（NPPV）治疗的儿童（患者）的临床病程进行了研究。在11例接受急性呼吸衰竭治疗的患者中，10例NPPV治疗有效；在9例接受慢性呼吸衰竭治疗的患者中，7例有效。12例患者接受NPPV治疗超过一年。所有患者均未出现与NPPV相关的并发症。在通气开始后不久，NPPV改善了通气障碍，除1例急性呼吸衰竭患者外，通过调整气道管理和面罩选择，避免了气管插管的需要。NPPV联合佩戴下颌带对存在口张开状态或上气道梗阻的患者非常有效。5例患者在使用NPPV从急性呼吸衰竭恢复后不久成功脱机，而5例在恢复后的慢性期继续使用NPPV的患者未出现急性呼吸衰竭复发。我们得出结论，NPPV可能是治疗伴有呼吸功能不全的SMID的有效方法。
