Aortic root diameter and nasal intermittent positive airway pressure treatment in Marfan's syndrome

We report on a patient with Marfan's syndrome, with coexistent obstructive sleep hypopnea (OSH) and restrictive lung disease, complicated by respiratory insufficiency, who was successfully treated with nasal intermittent positive airway pressure (NIPPV) and oxygen. NIPPV therapy turned out to be effective on arterial gas exchange and well tolerated. Moreover, progressive dilatation of the aortic root was attenuated during NIPPV, but could, however, not be reversed. We hypothetized that (at least partially) a decrease of nocturnal intrathoracic pressures could explain this.     

影响无创正压通气治疗重症COPD呼吸衰竭患者疗效的因素探讨

目的:探讨无创正压通气(NIPPV)治疗重症COPD呼吸衰竭患者影响疗效的因素.方法:对26例重症COPD呼吸衰竭(包括昏迷)患者,在通气第1～2天选择2种不同的面罩、呼吸机,先后进行无创正压通气.结果:通气结束时,24例依从性良好并完成NIPPV.普通面罩、随弃式面罩、小型呼吸机、大型呼吸机依从性良好,分别为9、24、15、24人次.结论:合适适应征的选择、面罩的特性、呼吸机的性能、技术因素及严密的监护是影响疗效的主要因素.     

无创通气在夜间哮喘并OSAHS中的临床作用

目的:探讨无创通气在夜间哮喘并阻塞型睡眠呼吸暂停低通气综合征(OSAHS)中的临床作用.方法:按时间顺序收集10例已确诊为夜间哮喘患者,收集患者的肺功能及睡眠监测数据并随访6个月.结果:合并OSAHS的哮喘患者,呼吸机治疗后哮喘及OSAHS症状均明显改善,P<0.05,有统计学差异.结论:合并OSAHS的哮喘患者,呼吸机治疗效果显著,哮喘症状得以控制,生活质量也明显改善.     

使用NIPPV成功救治重症社区获得性肺炎1例回顾

病历资料 患者,男,27岁,咳嗽,咳痰,气促,发热3天。患者自述于入院前3天在外地编织厂打工期间,因感冒后出现咳嗽、咳少量黄色黏痰,括动后气促,间断发热,最高体温达42℃,遂在当地诊所以“感冒”给予静滴“头孢哌酮,清开灵”抗感染、清热解毒等治疗2天无效,病情进行性加重。     

无创正压通气对妊娠合并肺水肿的疗效及胎儿的影响评价

目的评价无创正压通气（NIPPV）在妊娠合并肺水肿时的临床疗效和对胎儿的影响。方法回顾性分析38例妊娠合并肺水肿患者,随机分为对照组和治疗组,对照组给予常规综合治疗,治疗组在常规综合治疗基础上加用NIPPV,监测两组患者治疗前和治疗后30、60、120min的临床症状、体征、血气分析、每分心输出量（CO）和胎监评分,以及胎儿出生后的Apgar评分。2h后评定临床疗效。结果与对照组相比,治疗组治疗30、60、120min后SaO2、PaO2、PaO2/FiO2、CO、胎监评分、胎儿出生后1min的Apgar评分均显著增高（P〈0.05）,HR、RR显著降低（P〈0.05）,PaCO2、pH、MBP则差异无统计学意义（P〉0.05）,治疗2h后的临床总有效率和显效率均显著增高（P〈0.05）,治疗组无严重不良反应。结论无创正压通气是治疗妊娠合并肺水肿安全有效的方法,能显著改善胎儿宫内窘迫。     

无创通气救治间质性肺疾病合并呼吸衰竭的临床研究

目的 探讨无创机械通气治疗间质性肺疾病合并呼吸衰竭的临床效果及可行性.方法 选择2004年2月～2007年10月间我院收治的37例间质性肺疾病合并呼吸衰竭病人,随机分为治疗组和对照组,治疗组在对照组常规药物治疗基础上经面罩行无创通气,观察两组患者的症状、体征、血气改变及最后转归.结果 与对照组相比,治疗组患者病情和血气分析指标恢复较快.结论 无创通气治疗间质性肺疾病合并呼吸衰竭是安全有效和可行的,可减少并发症,挽救病人生命.     

慢性阻塞型肺疾病伴Ⅱ型呼吸衰竭患者实施无创通气最佳时机的探讨

目的探讨无创通气(NIPPV)用于治疗慢性阻塞性肺疾病(COPD)伴Ⅱ型呼吸衰竭患者的最佳时机。方法120例COPD患者随机分为NIPPV组和常规治疗组(对照组),在治疗前及治疗2 h、第3天观察两组血气、临床症状、肺功能和预后的变化。根据病情将患者分为轻、中、重三组,评价NIPPV的效果,选择应用NIPPV的最佳时机。结果NIPPV组在治疗2h后迅速改善了患者的心率、呼吸频率、呼吸困难评分、辅助呼吸肌动用评分和血气(P<0.05)。实施NIPPV后,患者的住院时间由20.6±28.9 d缩短至12.4±9.9 d,插管率由26.7%降至11.7%,病死率由13.3%降至3.3%(P<0.05)。轻、中度患者实施NIPPV的成功率较高,而重度患者的疗效不佳。结论COPD伴Ⅱ型呼吸衰竭患者应尽早使用NIPPV,应用NIPPV的最佳时机为50 mmHg相似文献   

BiPAP模式下行NIPPV辅助治疗急性左心衰竭疗效观察

目的探讨BiPAP模式下行无创正压通气（NIPPV）治疗急性左心衰竭的临床效果。方法将2008年2月至2011年7月在我院治疗的急性左心衰竭患者90例分为两组：BiPAP模式下行无创正压通气（NIPPV）组（简称BiPAP组）45例,常规应用抗心衰药物加BiPAP呼吸机进行NIPPV治疗;对照组45例只常规应用抗心衰药物治疗,比较两组患者治疗前后的症状、体征、血流动力学及血气分析参数。结果 BiPAP组患者治疗总有效率为88.9%,对照组为73.3%,两组比较差异无统计学意义（P〉0.05）;但治疗后BiPAP组患者PaO2上升,PaCO2、HR、MR、MAP下降更显著,与对照组比较差异有统计学意义（P〈0.05）。结论 BiPAP模式下经面罩行NIPPV治疗急性左心衰能迅速改善患者症状、体征及低氧血症,是一种快速安全有效的治疗方法,值得临床上推广应用。     

无创呼吸机质量状况调查及质量控制检测平台初步研究

目的:无创呼吸机广泛应用于临床和家庭,需准确评价无创呼吸机的质量性能。方法:利用VT plus HF气流分析仪检测无创呼吸机流量、压力、频率等参数。结果:检测12部无创呼吸机,合格率仅为66.7%。结论:需开发出不仅能检测CPAP,BIPAP,Auto-CPAP,Auto-BIPAP的流量、压力、频率等参数,还能定量检测Auto-CPAP,Auto-BIPAP被患者事件触发后调节流量、压力、频率等核心功能的智能质量控制检测仪。     

Follow-up study on pulmonary function and lung radiographic changes in rehabilitating severe acute respiratory syndrome patients after discharge

OBJECTIVES: To follow-up on the changes in lung function and lung radiographic pictures of severe acute respiratory syndrome (SARS) patients discharged from Xiaotangshan Hospital in Beijing (by regularly receiving examination), and to analyze retrospectively the treatment strategy in these patients. METHODS: Surviving SARS patients were seen at least twice within 3 months after discharge and underwent SARS-associated coronavirus (SARS-CoV) IgG antibody testing, pulmonary function testing, and chest radiography and/or high-resolution CT (HRCT) examinations at Chinese PLA General Hospital. The treatments received at Xiaotangshan Hospital were analyzed retrospectively and were correlated to later status. RESULTS: Positive SARS-Co virus IgG antibody results were seen in 208 of 258 patients, with 21.3% (55 of 258 patients) still having a pulmonary diffusion abnormality (D(LCO) < 80% of predicted). By comparing the 155 survivors with positive SARS-CoV IgG antibody results and D(LCO) > or = 80% predicted with the 50 patients with negative SARS-CoV IgG results, we found that 53 patients with positive SARS-CoV IgG results and a lung diffusion abnormality had endured a much longer course of fever and received larger doses of glucocorticoid, as well as higher ratios of oxygen inhalation and noninvasive ventilation treatment. For these patients, 51 of 53 patients with positive SARS-CoV IgG results and a lung diffusion abnormality underwent pulmonary function testing after approximately 1 month. D(LCO) improved in 80.4% of patients (41 of 51 patients). Of the patients with a lung diffusion abnormality, 40 of 51 patients showed lung fibrotic changes in the lung image examination and 22 patients (55%) showed improvement in lung fibrotic changes 1 month later. CONCLUSION: These findings suggest that lung fibrotic changes caused by SARS disease occurred mostly in severely sick patients and may be self-rehabilitated. D(LCO) scores might be more sensitive than HRCT when evaluating lung fibrotic changes.