Heckmatt J Z, Loh L, Dubowitz V
Department of Paediatrics, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
Pediatrics. 1989 Feb;83(2):250-5.
Eight patients between 4 and 24 years of age with nonprogressive neuromuscular disease sought medical attention because of severe nocturnal hypoventilation. There were two types of findings: subacute with progressive early morning headaches and daytime drowsiness and acute with ventilatory failure and cor pulmonale. Seven patients were ambulant. Seven were successfully treated with either a cuirass negative pressure ventilator or a positive pressure ventilator via a tracheostomy. The ventilatory assistance was only used at night and resulted in rapid resolution of early morning symptoms and a return to full daytime activity. One patient died as a result of an intercurrent respiratory infection before respiratory support could be given. It is important to be aware of this potentially life-threatening complication in patients with an otherwise good prognosis and of the benefit to be derived from active treatment.
8例4至24岁患有非进行性神经肌肉疾病的患者因严重夜间通气不足而就医。有两种类型的表现:亚急性型伴有进行性清晨头痛和日间嗜睡,急性型伴有呼吸衰竭和肺心病。7例患者可独立行走。7例患者通过胸甲式负压通气机或经气管造口的正压通气机成功治疗。通气辅助仅在夜间使用,可迅速缓解清晨症状并恢复全日正常活动。1例患者在给予呼吸支持前因并发呼吸道感染死亡。认识到在预后良好的患者中这种潜在的危及生命的并发症以及积极治疗的益处很重要。