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[64例神经肌肉疾病患者夜间鼻持续正压通气的良好效果;5年经验]

[Favorable results of nocturnal nasal positive-pressure ventilation in 64 patients with neuromuscular disorders; 5-year experience].

作者信息

van Kesteren R G, Kampelmacher M J, Dullemond-Westland A C, van Leyden L W, Verwey-van den Oudenrijn L P, Douze J M

机构信息

Academisch Ziekenhuis, Centrum voor Thuisbeademing, Utrecht.

出版信息

Ned Tijdschr Geneeskd. 1994 Sep 10;138(37):1864-8.

PMID:7935923
Abstract

OBJECTIVE

Evaluation of the effectiveness of chronic nightly mechanical ventilation through a nasal mask system in patients with neuromuscular diseases or patients with thorax malformations or COPD.

SETTING

Centre for Home Mechanical Ventilation, University Hospital Utrecht.

DESIGN

Retrospective study.

METHOD

During the period June 1988-May 1993, 64 patients (11-69 years old) were treated with nasal mask ventilation during the night: 37 men (most of whom had Duchenne's disease (18) and 27 women (most of whom had (post-polio) kyphoscoliosis (n = 13). The effects on arterial blood gases were analysed. Complications during use of the nasal mask systems were recorded.

RESULTS

The duration of the nasal mask ventilation was 2 to 56 months. Arterial PCO2 and PO2 improved during the night as well as by day during spontaneous respiration. The most common problems were necrosis of the skin of the bridge of the nose, leakage of air through the mouth or insufflation of air into the stomach. After the start of the mechanical ventilation quality of life improved considerably.

CONCLUSION

Nasal ventilation at night is sufficient and simple. The installation of a tracheostoma can be postponed or avoided with this non-invasive kind of ventilation.

摘要

目的

评估通过鼻罩系统进行慢性夜间机械通气对神经肌肉疾病患者、胸廓畸形患者或慢性阻塞性肺疾病(COPD)患者的有效性。

设置

乌得勒支大学医院家庭机械通气中心。

设计

回顾性研究。

方法

在1988年6月至1993年5月期间,64例年龄在11至69岁的患者在夜间接受鼻罩通气治疗:37例男性(其中大多数患有杜氏病(18例))和27例女性(其中大多数患有(小儿麻痹后遗症)脊柱后凸畸形(n = 13))。分析了对动脉血气的影响。记录了使用鼻罩系统期间的并发症。

结果

鼻罩通气的持续时间为2至56个月。夜间以及白天自主呼吸时动脉PCO₂和PO₂均有所改善。最常见的问题是鼻梁皮肤坏死、经口漏气或空气吹入胃内。开始机械通气后生活质量有显著改善。

结论

夜间鼻通气充足且简单。采用这种无创通气方式可推迟或避免气管造口术的施行。

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