Abstract

This is a patient with severe chronic obstructive pulmonary disease (COPD) complicated with sleep disturbance syndrome. Chronic hypercapnic respiratory failure for at least two years was noted when he was referred. Except standard medications for COPD at our outpatient department, the patient received home noninvasive positive pressure ventilation (NIPPV) for five years (from Jun, 2001 to Aug, 2005) and intermittent daytime oxygen therapy. We found significant decreases in PaCO2, HCO3 and BE. The FEV1 (0.53 L/min) did not decline at the fifth year; however, there was a significant increase in exercise tolerance half a year after NIPPV using. Nevertheless, even pulmonary rehabilitation programs at the our patient unit continuing, the condition deteriorated and admitting to the hospital due to secondary infection after three years of nocturnal ventilation. After stopping nocturnal NIPPV for three months in 2005, the patient developed respiratory failure, was intubated and became long-term ventilator dependent. It is therefore suggested that COPD patients complicated with sleep disturbance syndrome and has developed hypercapnic respiratory failure should long-term use nocturnal NIPPV, which has the potential to decrease admission rate and increase functional level of daily activity.
Original languageTraditional Chinese
Pages (from-to)1-13
Number of pages13
Journal呼吸治療
Volume8
Issue number1
DOIs
Publication statusPublished - 2009

Keywords

  • 慢性阻塞型肺疾
  • 非侵襲性正壓通氣
  • 夜間通氣支持
  • 慢性高碳酸呼吸衰竭
  • 睡眠呼吸障礙
  • Chronic obstructive pulmonary disease COPD
  • noninvasive positive pressure ventilation NIPPV
  • nocturnal ventilation
  • chronic hypercapnic respiratory failure
  • sleep disorder breathing

Cite this

一位慢性阻塞型肺疾患者五年居家非侵襲性正壓通氣之追蹤研究. / 盛德芳(Te-Fang Sheng); 曾媖琴(Ying-Chin Tseng); 何淑娟(Shun-Chuan Ho); 饒文琴(Wen-Ching Jao); 李岡遠(Kang-Yuan Li); 江玲玲(Ling-Ling Chiang).

In: 呼吸治療, Vol. 8, No. 1, 2009, p. 1-13.

Research output: Contribution to journalArticle

盛德芳(Te-Fang Sheng) ; 曾媖琴(Ying-Chin Tseng) ; 何淑娟(Shun-Chuan Ho) ; 饒文琴(Wen-Ching Jao) ; 李岡遠(Kang-Yuan Li) ; 江玲玲(Ling-Ling Chiang). / 一位慢性阻塞型肺疾患者五年居家非侵襲性正壓通氣之追蹤研究. In: 呼吸治療. 2009 ; Vol. 8, No. 1. pp. 1-13.
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abstract = "此爲一位合併睡眠呼吸障礙之嚴重型慢性阻塞型肺疾(chronic obstructive pulmonary disease, COPD)患者,接案時已呈現至少兩年以上合併高碳酸之慢性呼吸衰竭(chronic hypercapnic respiratory failure)。除正規慢性阻塞型肺疾門診藥物治療外,個案接受居家夜間鼻罩正壓通氣共約五年(90/6-95/8),並且白天偶爾氧氣使用。我們發現PaCO2降低,且HCO3、BE亦減低。第五年穩定時FEV1(0.53 L/min),與夜間鼻罩正壓通氣治療前相比並未變差;且居家夜間鼻罩正壓通氣使用半年以上時,運動耐力顯著增加。於夜間通氣三年後,個案常因二度感染病情惡化反覆住院,即使維持門診肺部復原治療,體力仍是差很多。於健保試停夜間鼻罩正壓通氣三個月後入院插管,現已成爲呼吸器長期依賴者。由此個案我們建議合併睡眠呼吸障礙之慢性阻塞型肺疾,並已出現高碳酸之慢性通氣衰竭患者,應維持夜間鼻罩正壓通氣治療,可降低住院頻率及提高日間生活功能。",
keywords = "慢性阻塞型肺疾, 非侵襲性正壓通氣, 夜間通氣支持, 慢性高碳酸呼吸衰竭, 睡眠呼吸障礙, Chronic obstructive pulmonary disease COPD, noninvasive positive pressure ventilation NIPPV, nocturnal ventilation, chronic hypercapnic respiratory failure, sleep disorder breathing, 慢性阻塞型肺疾, 非侵襲性正壓通氣, 夜間通氣支持, 慢性高碳酸呼吸衰竭, 睡眠呼吸障礙, Chronic obstructive pulmonary disease COPD, noninvasive positive pressure ventilation NIPPV, nocturnal ventilation, chronic hypercapnic respiratory failure , sleep disorder breathing",
author = "盛, {德芳(Te-Fang Sheng)} and 曾, {媖琴(Ying-Chin Tseng)} and 何, {淑娟(Shun-Chuan Ho)} and 饒, {文琴(Wen-Ching Jao)} and 李, {岡遠(Kang-Yuan Li)} and 江, {玲玲(Ling-Ling Chiang)}",
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language = "繁體中文",
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journal = "呼吸治療",
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AU - 盛, 德芳(Te-Fang Sheng)

AU - 曾, 媖琴(Ying-Chin Tseng)

AU - 何, 淑娟(Shun-Chuan Ho)

AU - 饒, 文琴(Wen-Ching Jao)

AU - 李, 岡遠(Kang-Yuan Li)

AU - 江, 玲玲(Ling-Ling Chiang)

PY - 2009

Y1 - 2009

N2 - 此爲一位合併睡眠呼吸障礙之嚴重型慢性阻塞型肺疾(chronic obstructive pulmonary disease, COPD)患者,接案時已呈現至少兩年以上合併高碳酸之慢性呼吸衰竭(chronic hypercapnic respiratory failure)。除正規慢性阻塞型肺疾門診藥物治療外,個案接受居家夜間鼻罩正壓通氣共約五年(90/6-95/8),並且白天偶爾氧氣使用。我們發現PaCO2降低,且HCO3、BE亦減低。第五年穩定時FEV1(0.53 L/min),與夜間鼻罩正壓通氣治療前相比並未變差;且居家夜間鼻罩正壓通氣使用半年以上時,運動耐力顯著增加。於夜間通氣三年後,個案常因二度感染病情惡化反覆住院,即使維持門診肺部復原治療,體力仍是差很多。於健保試停夜間鼻罩正壓通氣三個月後入院插管,現已成爲呼吸器長期依賴者。由此個案我們建議合併睡眠呼吸障礙之慢性阻塞型肺疾,並已出現高碳酸之慢性通氣衰竭患者,應維持夜間鼻罩正壓通氣治療,可降低住院頻率及提高日間生活功能。

AB - 此爲一位合併睡眠呼吸障礙之嚴重型慢性阻塞型肺疾(chronic obstructive pulmonary disease, COPD)患者,接案時已呈現至少兩年以上合併高碳酸之慢性呼吸衰竭(chronic hypercapnic respiratory failure)。除正規慢性阻塞型肺疾門診藥物治療外,個案接受居家夜間鼻罩正壓通氣共約五年(90/6-95/8),並且白天偶爾氧氣使用。我們發現PaCO2降低,且HCO3、BE亦減低。第五年穩定時FEV1(0.53 L/min),與夜間鼻罩正壓通氣治療前相比並未變差;且居家夜間鼻罩正壓通氣使用半年以上時,運動耐力顯著增加。於夜間通氣三年後,個案常因二度感染病情惡化反覆住院,即使維持門診肺部復原治療,體力仍是差很多。於健保試停夜間鼻罩正壓通氣三個月後入院插管,現已成爲呼吸器長期依賴者。由此個案我們建議合併睡眠呼吸障礙之慢性阻塞型肺疾,並已出現高碳酸之慢性通氣衰竭患者,應維持夜間鼻罩正壓通氣治療,可降低住院頻率及提高日間生活功能。

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KW - 慢性高碳酸呼吸衰竭

KW - 睡眠呼吸障礙

KW - Chronic obstructive pulmonary disease COPD

KW - noninvasive positive pressure ventilation NIPPV

KW - nocturnal ventilation

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KW - 非侵襲性正壓通氣

KW - 夜間通氣支持

KW - 慢性高碳酸呼吸衰竭

KW - 睡眠呼吸障礙

KW - Chronic obstructive pulmonary disease COPD

KW - noninvasive positive pressure ventilation NIPPV

KW - nocturnal ventilation

KW - chronic hypercapnic respiratory failure

KW - sleep disorder breathing

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DO - 10.6269/JRT.2009.8.1.01

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JO - 呼吸治療

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