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继发于非阻塞性通气障碍的慢性呼吸衰竭5例病人,用负压通气(NPV)减轻睡眠引起的肺泡通气降低并得到长期临床好转。睡眠对照组研究发现,从觉醒时至睡眠非快速眼动期的动脉血氧饱和度由81±6%降到79±1%,于睡眠快速眼动期降到67±3%,经皮PCO_2从觉醒及睡眠非快速眼动至快速眼动期时,从80±16mmHg 增高到87±16 mmHg 用胸衣通气机(Cuirass ventilator)进行夜间NPV 能改善觉醒时的基础通气,并防止睡眠时的肺泡通气恶化.由于NPV 引起睡眠时的上呼吸道阻塞,给与三环类药物(普罗替林)或经鼻CPAP 可得到满意的疗效。经过8周的夜间NPV 治疗,病人都感觉很好,白天休息时的PaCO_2从56±2降到46±3 mmHg,(p<0.05)及PaCO_2从51±9增高到70±10 mmHg(NS)。4例病人在家持续规律的用NPV 治疗,已恢复全日工
Five patients with chronic respiratory failure secondary to non-obstructive ventilatory disorders were treated with negative pressure ventilation (NPV) to reduce sleep-induced alveolar hypoventilation and to achieve long-term clinical improvement. In the sleep control group, arterial oxygen saturation decreased from 81 ± 6% to 79 ± 1% during sleep-fast to non-REM and down to 67 ± 3% during REM sleep, while percutaneous PCO_2 Increasing from 80 ± 16 mmHg to 87 ± 16 mmHg from awake and sleep non-REM to REMD Night nocturnal NPV with a Cuirass ventilator improves basal ventilation during wakefulness and prevents sleep-deprived Alveolar Ventilation Deterioration Because NPV causes upper airway obstruction during sleep, satisfactory results can be obtained with tricyclic drugs (protriptyline) or nasal CPAP. After eight weeks of nocturnal NPV treatment, the patients felt good with PaCO 2 reduction from 56 ± 2 to 46 ± 3 mmHg at daytime rest (p <0.05) and PaCO 2 increased from 51 ± 9 to 70 ± 10 mmHg (NS) . Four patients were treated regularly with NPV at home and resumed full-time work