肌萎缩侧索硬化患者呼吸支持和营养管理

Respiratory support and nutrition management in amyotrophic lateral sclerosis

呼吸衰竭和呼吸系统并发症是导致肌萎缩侧索硬化(ALS)患者死亡的最常见原因。呼吸支持,特别是无创双水平正压通气治疗可以改善患者的生存质量同时延长存活时间,现在已逐渐被大家所重视。另外,营养不良是肌萎缩侧索硬化独立的不良预后因素,其发生主要与吞咽困难等因素有关。经皮内镜胃造瘘术能保证足够的能量摄入,对改善营养状况、提高存活期等有效。本文就ALS患者给予无创通气治疗、经皮内镜胃造瘘治疗的益处、指征进行了总结。

Respiratory failure and respiratory complication are most reasons that result in death of ALS patients. Respiratory support, especially non-invasive Bi-level positive airway pressure, may improve living quality and prolong survival time. Treatment of respiratory, support was gradually accepted and focused in the worldwide. In addition,malnutrition is an independent poor prognostic factor for ALS. Percutaneous endoscopic gastrostomy can ensure enough energy intake, improve nutritional status and prolong survival time. The profit and indication of BiPAP and PEG were summarized.