与非侵入性正压通风在肌缩侧面硬化症的坚持相关的因素
Hee Soo Kim1, Hyeonseong Woo1, Seok-Jin Choi2
1Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea.
PloS one
|May 15, 2024
概括
早期非侵入性正压通风 (NIPPV) 在肌缩侧面硬化症 (ALS) 患者的CO2保留和降低生命能力改善了坚持. 坚持NIPPV与更长的无气管切除术生存率和减少气管切除术转换率有关.
科学领域:
- 神经学 神经学
- 肺部病理学 肺部病理学
- 医疗技术 医疗技术 医学技术
背景情况:
- 肌缩侧面硬化症 (ALS) 是一种进展性神经退行性疾病,影响运动神经元.
- 非侵入性正压通风 (NIPPV) 是ALS患者的关键呼吸支持.
- 了解影响NIPPV遵守的因素及其长期影响对于患者管理至关重要.
研究的目的:
- 调查与ALS患者的NIPPV坚持相关的因素.
- 评估NIPPV坚持对生存和临床结果的长期影响.
- 在这个人群中确定成功使用NIPPV的预测因素.
主要方法:
- 对51名开始NIPPV.ALS的ALS患者的医疗记录的回顾性审查.
- 评估肺功能,血液气体分析,症状发作,NIPPV,ALSFRS-R的时间,神经生理指数和住院时间.
- 定义为使用≥2小时/天或≥4小时/天;进行相关性分析.
主要成果:
- 坚持患者在症状发作/诊断后16个月早些时候接受了NIPPV.
- 在附着组中观察到的引指数最小肌肉中较高的神经生理指数.
- NIPPV的坚持与长时间的无气管切除生存相关.
- 脱事件和较低的FVC等因素与更长的住院时间有关.
结论:
- 症状出现和诊断后及时启动NIPPV,特别是在二氧化碳保留和减少FVC的患者中,促进了坚持.
- NIPPV的坚持可能会降低气管切除术转换率.
- 在ALS患者中,坚持NIPPV与改善无气管切除术的生存率有关.
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