摘要
目的探讨长期家庭机械通气治疗儿童慢性呼吸衰竭的可行性和安全性。方法回顾性分析于2013年1月至2019年12月在厦门大学附属第一医院开展长期家庭机械通气治疗的11例慢性呼吸衰竭患儿的临床资料、生长发育情况、生命质量、不良事件及预后。结果11例患儿中,男性8例,女性3例,发病年龄为26 d~13岁,开始家庭机械通气的年龄为3个月~13岁。8例原发病为神经肌肉疾病,3例为呼吸道疾病。11例患儿医院内机械通气时间最短者2周,最长者8个月。6例机械通气的方式为气管造口+有创通气,5例为鼻/面罩+无创通气,11例患儿均采用双水平气道正压通气,家庭机械通气时间为3~27个月。随访至2020年3月31日,11例患儿耐受性可、生命质量提高、营养状况改善、安全性可;1例随访9个月后失访,1例因住院检查继发重症腺病毒肺炎死亡以外,其余9例均存活,其中4例已停用呼吸机治疗,4例曾因肺炎再次入院治疗1~2次,所有患儿均未发生与使用家庭呼吸机相关的不良事件。结论儿童家庭机械通气治疗安全性良好,对于慢性呼吸衰竭患儿来说是一种可探索的长期治疗方案。
Objective To explore the feasibility and safety of long-term home mechanical ventilation(HMV)in children with chronic respiratory failure.Methods Clinical data of 11 children with chronic respiratory failure,who underwent HMV with the care of the First Affiliated Hospital of Xiamen University from January 2013 to December 2019,were retrospectively reviewed.The clinical manifestation,growth and development,quality of life,adverse events and prognosis of HMV children were analyzed.Results There were 8 boys and 3 girls with the onset age of 26 days to 13 years old;and the age at starting HMV was 3 months to 13 years old.Eight children were diagnosed as neuromuscular diseases,and 3 children were diagnosed as respiratory diseases.The duration of institutional mechanical ventilation was 2 weeks to 8 months.Six patients underwent invasive HMV via a tracheostomy,and 5 received non-invasive ventilation via nasal and face masks.Bi-level positive airway pressure ventilation mode was applied in all the patients.The duration of HMV was 3 months to 27 months.During follow-up,no HMV related adverse events were observed.Both the quality of life and nutritional status were improved in all cases.One patient lost follow-up 9 months later and 1 patient died of severe adenovirus pneumonia during hospitalization for examination,the remaining 9 cases survived.Liberation from HMV was obtained in 4 patients.The frequency of readmission was 1 to 2 times.Conclusion It is suggested that long-term HMV is safe and feasible for children with chronic respiratory failure.
作者
朱碧溱
林丽华
吴谨准
陈国兵
杨运刚
Zhu Bizhen;Lin Lihua;Wu Jinzhun;Chen Guobing;Yang Yungang(Department of Pediatrics,the First Affiliated Hospital of Xiamen University,Pediatric Key Laboratory of Xiamen,Institute of Pediatrics,Xiamen University School of Medicine,Xiamen 361003,China)
出处
《中华全科医师杂志》
2021年第1期84-88,共5页
Chinese Journal of General Practitioners
关键词
呼吸功能不全
儿童
家庭机械通气
Respiratory insufficiency
Child
Home mechanical ventilation
