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[囊性纤维化患儿经鼻面罩机械通气。一种无创方法的初步结果]

[Mechanical ventilation by nasal mask in children with cystic fibrosis. Initial results of a non-invasive method].

作者信息

Baculard A, Bedicam J M, Sardet A, Fauroux B, Tournier G

机构信息

Service de Pédiatrie et Pneumologie de l'enfant, Hôpital Trousseau, Paris.

出版信息

Arch Fr Pediatr. 1993 Jun-Jul;50(6):469-74.

PMID:8135605
Abstract

BACKGROUND

Chronic respiratory failure (CRF) with hypoxia and hypercapnia is the last ineluctable phase in cystic fibrosis (CF). Nasal positive pressure ventilation (NPPV), a non-invasive method, may be given to CF children with CRF, especially to patients accepted for transplantation (T). This method improves ventilatory function by resting the chronically exhausted respiratory muscles, facilitates bronchial drainage by physiotherapy, prevents the exacerbations of the illness and prepares patients for T.

METHODS AND PATIENTS

NPPV was used in 6 CF patients (mean age 13 years 6 months). One of them was transplanted 15 days later, two of them were accepted for T. All had hypoxia. Five of them had hypercapnia.

RESULTS

NPPV was given to four patients for 3 to 14 months. The preliminary results were positive. One patient gained weight, two had more fluid sputum. One patient showed an increase in functional respiratory tests (FRT: PaO2, vital capacity, FEV-1) while these tests were stabilized in the others.

CONCLUSIONS

NPPV in an effective non-invasive method for use with CF children. It is indicated for CF patients accepted for T and also earlier, for CF patients with CRF in order to prevent acute exacerbations and functional respiratory deterioration.

摘要

背景

伴有低氧血症和高碳酸血症的慢性呼吸衰竭(CRF)是囊性纤维化(CF)的最后一个不可避免的阶段。鼻正压通气(NPPV)作为一种非侵入性方法,可用于患有CRF的CF儿童,尤其是接受移植(T)的患者。该方法通过使长期疲惫的呼吸肌得到休息来改善通气功能,通过物理治疗促进支气管引流,预防疾病加重,并为患者接受移植做准备。

方法与患者

6例CF患者(平均年龄13岁6个月)使用了NPPV。其中1例在15天后接受了移植,2例被纳入移植名单。所有患者均有低氧血症。5例有高碳酸血症。

结果

4例患者接受NPPV治疗3至14个月。初步结果是积极的。1例患者体重增加,2例痰液增多。1例患者的功能性呼吸测试(FRT:动脉血氧分压、肺活量、第1秒用力呼气容积)有所改善,而其他患者的这些测试结果稳定。

结论

NPPV是用于CF儿童的一种有效的非侵入性方法。适用于被纳入移植名单的CF患者,对于患有CRF的CF患者也可更早使用,以预防急性加重和功能性呼吸恶化。

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