Schlenker E, Feldmeyer F, Hoster M, Rühle K H
Klinik Ambrock, Hagen.
Med Klin (Munich). 1997 Apr 28;92 Suppl 1:40-4. doi: 10.1007/BF03041809.
Many studies have shown, that non invasive ventilation via nasal access can normalize alveolar ventilation for individuals due to kyphoscoliotic deformity. The purpose of this study was to evaluate the effect of nasal IPPV on the pulmonary artery pressures (Pam) and the sleep efficiency of kyphoscoliotic individuals.
Five patients were studied (4 men, 1 woman; age 50.5 +/- 6.9 years): all patients showed hypoxemia and hypercapnia before therapy. We followed the patients about 6 months under NIPPV. We measured PImax, PaO2, PaCO2, Pam before and after 6 months with NIPPV.
PImax increased from 4.9 +/- 2.3 kPa to 6.5 +/- 1.3 kPa, PaO2 increased from 46.2 +/- 12.2 mmHg to 56.7 +/- 8.5 mmHg. PaCO2 decreased from 53.0 +/- 3.2 to 45.3 +/- 3.2. Pam decreased from 41.0 +/- 15.1 to 23.2 +/- 10.7 in 6 months of NIPPV. Total sleep time increased from 222 +/- 52 min to 326 +/- 43 min with NIPPV.
Similar to O2 long-term therapy in patients with COPD. NIPPV delivers in patients with kyphoscoliotic deformity a significant reduction of pulmonary artery pressure and increase of sleep quality.
许多研究表明，对于脊柱后侧凸畸形患者，经鼻无创通气可使肺泡通气恢复正常。本研究的目的是评估经鼻间歇正压通气（IPPV）对脊柱后侧凸患者肺动脉压（Pam）和睡眠效率的影响。
对5例患者进行了研究（4例男性，1例女性；年龄50.5±6.9岁）：所有患者在治疗前均表现为低氧血症和高碳酸血症。我们对患者进行了约6个月的无创正压通气（NIPPV）随访。在NIPPV治疗6个月前后，我们测量了最大吸气压力（PImax）、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）和肺动脉压（Pam）。
PImax从4.9±2.3 kPa增加到6.5±1.3 kPa，PaO2从46.2±12.2 mmHg增加到56.7±8.5 mmHg。PaCO2从53.0±3.2降至45.3±3.2。在NIPPV治疗6个月时，Pam从41.0±15.1降至23.2±10.7。NIPPV治疗后总睡眠时间从222±52分钟增加到326±43分钟。
与慢性阻塞性肺疾病（COPD）患者的长期氧疗相似，NIPPV可使脊柱后侧凸畸形患者的肺动脉压显著降低，睡眠质量提高。
