|
|
|
| A cases report of amyotrophic lateral sclerosis with type Ⅱ respiratory failure |
| HE Lingxiao LIANG Yan |
| Neurology of Department, West China Hospital, Sichuan University, Sichuan Province, Chengdu 610041, China |
|
|
|
Abstract ALS patients always occure respiratory muscle weakness, acute respiratory failure and respiratory muscle paralysis caused by pulmonary infection are the most common cause of death in ALS patients. It is very important for ALS patients to be evaluated regularly and timely hospitalized assessment. This article reviews the respiratory support process of an ALS patients with acute type Ⅱ respiratory failure. After the patient admitted to hospital, the blood gas analysis suggested that type Ⅱ respiratory failure, according to the patient's breathing state, blood gas analysis results and personal wishes, he was treated with non-invasive ventilation, tracheal intubation assisted ventilation and tracheotomy after transferred into the neurological ICU by sequence, and given adequate nutritional support, Antibiotic treatment of infection, expectorant and other symptomatic treatment care at the same time. After the systematic treatment, the patient's condition became stable and transferred to long-term carefacility. Generally, in patients with auxiliary ventilation indications, choosing the appropriate respiratory support measures and regular adjustments according to the disease and personal wishes can help improve the patients' respiratory function.
|
|
|
|
|
|
[1] Miller RG，Brooks BR，Swaineng RJ，et al. Quality improvement in neurology: amyotrophic lateral sclerosis quality measures [J]. Neurology，2014，81（3-4）：2136-2140.
[2] Tsai CP，Chang BH，Lee CT. Underlying cause and place of death among patients with amyotrophic lateral sclerosis in Taiwan：a population-based study，2003-2008 [J]. Journal of Epidemiology，2013，23（6）：424-428.
[3] Spataro R，Re M L，Piccoli T，et al. Causes and place of death in Italian patients with amyotrophic lateral sclerosis [J]. Acta Neurologica Scandinavica，2010，122（3）：217-223.
[4] Rong Y，Rui H，Chen D，et al. Causes and places of death of patients with amyotrophic lateral sclerosis in south-west China [J]. Amyotrophic Lateral Sclerosis，2011，12（3）：206-209.
[5] Lechtzin N. Causes of death amongst French patients with amyotrophic lateral sclerosis： is guideline recommended care getting lost in translation? [J]. European Journal of Neurology，2009，16（1）：5-6.
[6] 蔡珏，支惠萍.运动神经元病患者的呼吸支持管理进展[J].神经病学与神经康复学杂志，2009，6（2）： 151-153.
[7] Brochard L，Martin GS，Blanch L，et al. Clinical review：respiratory monitoring in the ICU——a consensus of 16 [J]. Critical Care，2012，16（2）：1-14.
[8] Howell BN，Newman DS. Dysfunction of central control of breathing in amyotrophic lateral sclerosis [J]. Muscle & Nerve，2017，56（2）：197-201.
[9] Group GD. Motor neurone disease： the use of non-invasive ventilation in the management of motor neurone disease [R]. London：National Institute for Health & Clinical Excellence，2010.
[10] 中华医学会神经病学分会肌电图与临床神经电生理学组.中国肌萎缩侧索硬化诊断和治疗指南[J].中华神经科杂志，2012，45（7）：531-533.
[11] Sancho J，Servera E，Díaz JL，et al. Home tracheotomy mechanical ventilation in patients with amyotrophic lateral sclerosis：causes，complications and 1-year survival [J]. Thorax，2011，66（11）：948-952.
[12] Burkhardt C，Neuwirth C，Sommacal A，et al. Is survival improved by the use of NIV and PEG in amyotrophic lateral sclerosis （ALS）? A post-mortem study of 80 ALS patients [J]. Plos One，2017，12（5）：e0177555.
[13] Bach JR，Bianchi C，Aufiero E. Oximetry and indications for tracheotomy for amyotrophic lateral sclerosis [J]. Chest，2004，126（5）：1502-1507.
[14] Banfi P，Ticozzi N，Lax A，et al. A review of options for treating sialorrhea in amyotrophic lateral sclerosis[J]. Respiratory Care，2015，60（3）：446-454.
[15] 中华医学会呼吸病学分会呼吸治疗学组. 成人气道分泌物的吸引专家共识（草案）[J].中华结核和呼吸杂志，2014，37（11）：809-811. |
|
|
|
