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[慢性呼吸衰竭——居家机械通气存活九年]

[Chronic respiratory failure--survival for nine years with home mechanical ventilation].

作者信息

Hiramine Y, Ichinose Y, Torii Y, Yonemaru M, Toyama K, Ishihara D, Takasugi T, Kawashiro T

机构信息

First Department of Internal Medicine, Tokyo Medical College.

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Nov;33(11):1265-9.

PMID:8583719
Abstract

We report the case of a woman, now 58 years old, with chronic respiratory failure due to spinal progressive muscular atrophy. She first noticed gradual progressive muscular weakness in her extremities in 1973. She started to complain of dyspnea on exertion in 1978. Chronic respiratory failure due to spinal progressive muscle atrophy was diagnosed in 1983. Home oxygen therapy was begun, but CO2 narcosis and exacerbation of chronic respiratory failure occurred at the end of that year. A tracheotomy was done and mechanical ventilation was begun. As her general condition improved and she could breathe without the ventilator for a few hours each day, home mechanical ventilation was begun. Seven years later, her general condition is still good and she can live without any life-threatening distress. There are few reports of patients in Japan who have survived for long periods of time with home mechanical ventilation. We believe that improvement in her respiratory care and in her social situation contributed to her long standing clinical course.

摘要

我们报告了一例现年58岁的女性病例,她因脊髓性进行性肌萎缩导致慢性呼吸衰竭。1973年,她首次注意到四肢逐渐出现进行性肌无力。1978年,她开始抱怨活动时呼吸困难。1983年,诊断出脊髓性进行性肌萎缩导致的慢性呼吸衰竭。开始进行家庭氧疗,但在当年年底出现了二氧化碳麻醉和慢性呼吸衰竭加重的情况。进行了气管切开术并开始机械通气。随着她的一般状况改善,她每天可以在不使用呼吸机的情况下呼吸几个小时,于是开始了家庭机械通气。七年后,她的一般状况仍然良好,能够在没有任何危及生命的困扰下生活。在日本,很少有患者通过家庭机械通气存活很长时间的报道。我们认为,她的呼吸护理和社会状况的改善促成了她长期的临床病程。

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