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[肌萎缩侧索硬化症患者使用与未使用机械通气的对比研究]

[A comparative study between amyotrophic lateral sclerosis patients with and without mechanical ventilation].

作者信息

Kamimoto K, Murakami N, Muroga T, Matsubara M, Yamamoto M

出版信息

Rinsho Shinkeigaku. 1989 Aug;29(8):989-93.

PMID:2598532
Abstract

Fifty-three patients with amyotrophic lateral sclerosis (ALS) were examined as to duration of illness, cause of death and need for respirator assistance. In 47 patients with ALS, respiratory failure is the most common cause of death accounting for 62% of all fatalities. Eleven patients with mechanical ventilation died of pneumonia and respiratory failure in four cases, atelectasis, gastrointestinal bleeding and asphyxia in one. Thirteen of 53 patients with ALS required mechanical ventilation. Six cases were put on a volume-limited respiratory or a pressure-limited respirator with O2 blender, and seven cases were put on a pressure-limited respirator only, which was unable to control oxygen concentration. As to the duration of their illness, patients with mechanical ventilation survived significantly longer than those without mechanical ventilation, so patients using a respirator could expect to live significantly longer than those without one. Patients using a volume limited respirator or a pressure-limited respirator with O2 blender had significantly longer duration of mechanical ventilation than those using a pressure-limited respirator only. It is concluded that a volume-limited respirator or a pressure-limited respirator with O2 blender is useful, if mechanical ventilation is needed, for ALS patients presenting with respiratory failure.

摘要

对53例肌萎缩侧索硬化症(ALS)患者进行了疾病持续时间、死因及呼吸辅助需求方面的检查。在47例ALS患者中,呼吸衰竭是最常见的死因,占所有死亡病例的62%。11例接受机械通气的患者死于肺炎,4例死于呼吸衰竭,1例死于肺不张、胃肠道出血和窒息。53例ALS患者中有13例需要机械通气。6例使用容量限制型呼吸机或带氧气混合器的压力限制型呼吸机,7例仅使用压力限制型呼吸机,后者无法控制氧气浓度。就疾病持续时间而言,接受机械通气的患者存活时间显著长于未接受机械通气的患者,因此使用呼吸机的患者预期寿命显著长于未使用呼吸机的患者。使用容量限制型呼吸机或带氧气混合器的压力限制型呼吸机的患者机械通气持续时间显著长于仅使用压力限制型呼吸机的患者。得出的结论是,如果需要机械通气,容量限制型呼吸机或带氧气混合器的压力限制型呼吸机对出现呼吸衰竭的ALS患者有用。

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