夜间经鼻面罩持续正压辅助通气治疗中枢性低通气  

Management of nocturnal nasal mask CPAP in centralhypoventilation patients of Respiratory Diseases Peking

作　　者：于丽[1] 黄席珍[1] 吴全有[1] 朱元珏[1] 

机构地区：[1]北京协和医院

出　　处：《中华结核和呼吸杂志》1994年第1期38-40,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：报告４例不同原因所致的中枢性低通气病人夜间应用经鼻面罩持续正压通气的疗效反应。４例病人分别于治疗前、吸氧２Ｌ／ｍｉｎ及应用通气治疗后行多导睡眠图检查比较夜间低通气及血氧情况，结果示单纯吸氧不能明显改善低通气次数和低氧情况，最低氧饱和度均＜５０％，低通气指数３例仍＞２０ｂ／ｈ（正常值＜５ｂ／ｈ），另１例为６４ｂ／ｈ；予以持续正压通气机通气治疗，压力调至６～１２ｃｍＨ２Ｏ（１ｃｍＨ＿２Ｏ＝０．０９８ｋＰａ）时，低通气指数及低氧血症明显改善，最低氧饱和度均＞７０％，Ｐ＜０．００１，低通气指数均＜７ｂ／ｈ，Ｐ＜０．０１。结论：夜间应用鼻面罩持续正压通气治疗中枢性低通气的初步结果示疗效显著。he effect of nasal mask CPAP administered dur-ing night in four central hypoventilation patients withvarious causes were investigated. On the basis of theirhistories, specific clinical manifestations, cranial CTand MRI, cerebral angiography andpolysomnography. The patients (three males and onefemale) are diagnosed as primary alveolarhypoventilation and eentral hypoventilation, the latermainly caused by the compr.ession of bulbarrespiratory centre due to congenital defoimity of rightvertebral artery and defomiity of foramen magnum. Inorder to assess the severity of noctunialhypoventiiation and blood oxygen level of thepatients. polysomnography was taken before treat-ment. during 2L / min of oxygen via nasal tube andCPAP ventilation. Only oxygen administration did notameliorate hypoventilation episodes and hypoxemia,lowest SaOzis less than 50% on four patients,hypoventilation index is greater than 20 times / hourin three patients and 6.4 in a patient. Applying CPAPwith the pressure fixed to 6～ 12cm H_2O cansignificantly improve hypoventilation index andhypoxemia with lowest Saozmore than 70%(Pmo.001) and hypoventilation index less than 7(P<0.01). We conclude that nocturnal nasal maskCPAP is an effective treatment for centralhypoventilation.

关 键 词：换气不足 人工呼吸 

分 类 号：R563.8[医药卫生—呼吸系统]