国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2009年
13期
784-787
,共4页
肖高辉%顾蕾%席新蕊%单晓宇%黄席珍
肖高輝%顧蕾%席新蕊%單曉宇%黃席珍
초고휘%고뢰%석신예%단효우%황석진
慢性充血性心力衰竭%无创正压通气%陈-施呼吸%压力支持自动伺服通气%双水平无创正压通气
慢性充血性心力衰竭%無創正壓通氣%陳-施呼吸%壓力支持自動伺服通氣%雙水平無創正壓通氣
만성충혈성심력쇠갈%무창정압통기%진-시호흡%압력지지자동사복통기%쌍수평무창정압통기
Chronic congestive heart failure%Non-invasive positive pressure ventilation%Cheyne-stoke respiration%Autoset CS%Bilevel PAP
目的 比较两种无创呼吸机治疗慢性充血性心力衰竭合并陈-施呼吸(cheyne-stoke respiration,CSR)患者效果.方法 选取北京市公安医院2例慢性充血性心力衰竭合并CSR患者,针对患者病情给予患者常规治疗,并在常规治疗的基础上分别采用压力支持自动伺服通气(Autoset CS)以及双水平无创正压通气(Bilevel PAP)进行治疗.比较治疗前后的呼吸频率、心率、血气变化情况(pH、PaO2、PaCO2、SaO2)、收缩压、舒张压、左室射血分数等情况.同时注意观察患者接受治疗后的不良反应,例如:局部皮肤损伤、鼻炎、明显腹胀、气压伤、误吸、低血压等.结果 采用Autoset CS治疗CSR显示出不仅有睡眠质量的提高、白天嗜睡的减轻及认知度的改善,而且心力衰竭患者的左室射血分数及心功能都有明显改善.另外采用BilevelPAP经鼻无创通气治疗CSR其参数设定吸气压通常为10.0 cm H2O;呼气压通常为6～8 cm H2O即可.吸气时间较治疗慢性阻塞性肺疾病的参数有所延长,通常为0.5～0.6 s;呼气时间较治疗慢性阻塞性肺疾病的参数有所减少,通常为0.3 S.结论 Autoset CS治疗CSR采用自动调节的伺服通气运算,提供一种全新的无创正压通气治疗形式,更及时完全地控制CSR.BilevelPAP经鼻无创通气治疗CSR其参数设定与治疗慢性阻塞性肺疾病的参数设定显著的不同.
目的 比較兩種無創呼吸機治療慢性充血性心力衰竭閤併陳-施呼吸(cheyne-stoke respiration,CSR)患者效果.方法 選取北京市公安醫院2例慢性充血性心力衰竭閤併CSR患者,針對患者病情給予患者常規治療,併在常規治療的基礎上分彆採用壓力支持自動伺服通氣(Autoset CS)以及雙水平無創正壓通氣(Bilevel PAP)進行治療.比較治療前後的呼吸頻率、心率、血氣變化情況(pH、PaO2、PaCO2、SaO2)、收縮壓、舒張壓、左室射血分數等情況.同時註意觀察患者接受治療後的不良反應,例如:跼部皮膚損傷、鼻炎、明顯腹脹、氣壓傷、誤吸、低血壓等.結果 採用Autoset CS治療CSR顯示齣不僅有睡眠質量的提高、白天嗜睡的減輕及認知度的改善,而且心力衰竭患者的左室射血分數及心功能都有明顯改善.另外採用BilevelPAP經鼻無創通氣治療CSR其參數設定吸氣壓通常為10.0 cm H2O;呼氣壓通常為6～8 cm H2O即可.吸氣時間較治療慢性阻塞性肺疾病的參數有所延長,通常為0.5～0.6 s;呼氣時間較治療慢性阻塞性肺疾病的參數有所減少,通常為0.3 S.結論 Autoset CS治療CSR採用自動調節的伺服通氣運算,提供一種全新的無創正壓通氣治療形式,更及時完全地控製CSR.BilevelPAP經鼻無創通氣治療CSR其參數設定與治療慢性阻塞性肺疾病的參數設定顯著的不同.
목적 비교량충무창호흡궤치료만성충혈성심력쇠갈합병진-시호흡(cheyne-stoke respiration,CSR)환자효과.방법 선취북경시공안의원2례만성충혈성심력쇠갈합병CSR환자,침대환자병정급여환자상규치료,병재상규치료적기출상분별채용압력지지자동사복통기(Autoset CS)이급쌍수평무창정압통기(Bilevel PAP)진행치료.비교치료전후적호흡빈솔、심솔、혈기변화정황(pH、PaO2、PaCO2、SaO2)、수축압、서장압、좌실사혈분수등정황.동시주의관찰환자접수치료후적불량반응,례여:국부피부손상、비염、명현복창、기압상、오흡、저혈압등.결과 채용Autoset CS치료CSR현시출불부유수면질량적제고、백천기수적감경급인지도적개선,이차심력쇠갈환자적좌실사혈분수급심공능도유명현개선.령외채용BilevelPAP경비무창통기치료CSR기삼수설정흡기압통상위10.0 cm H2O;호기압통상위6～8 cm H2O즉가.흡기시간교치료만성조새성폐질병적삼수유소연장,통상위0.5～0.6 s;호기시간교치료만성조새성폐질병적삼수유소감소,통상위0.3 S.결론 Autoset CS치료CSR채용자동조절적사복통기운산,제공일충전신적무창정압통기치료형식,경급시완전지공제CSR.BilevelPAP경비무창통기치료CSR기삼수설정여치료만성조새성폐질병적삼수설정현저적불동.
Objective To compare the effect of two non-invasive positive pressure ventilations in treating patients of chronic congestive heart failure with complications of Cheyne-Stoke respiration(CSR). Methods Two patients of chronic congestive heart failure with complications of CSR were given conventional treatment plus adaptive-service ventilation(Autoset CS) or Bilevel PAP respectively. Parameters including respiratory rate, heart rate, pH, PaO2, PaCO2, SaO2, SBP, DBP, left ventricular ejection factor (LVEF) were measured and compared for two patients before and after treatment. Side effects including dermatitis,rhinitis, abdomen bulge, air pressure injury, mis-inhalation, and hypotension were monitored. Results Autoset CS treatment of CSR gave the patients a better sleep, alleviated sleep-addiction and improved cognition,as well as significant improvement of LVEF and cardiac function. In intranasal Bilevel PAP treatment of CSR,IP and EP were usually set to 10.0 cm H2O and 6-8 cm H2O respectively. I-slope generally took 0.5-0.6 seconds, relatively longer than chronic obstructive lung diseases, while E-slope was approximately 0.3 seconds, generally shorter than chronic obstructive lung diseases. Conclusions Autoset CS provides a novel approach in treating CSR. Different settings of parameters should be applied in treating CSR with Bilevel PAP as compared to chronic obstructive lung diseases.
