alveolar hypoventilation syndrome
Introduction
Introduction to alveolar hypopnea syndrome Alveolar hypoventilation syndrome (alveolarhypoventilationsyndrome) refers to the alveolar ventilation can not meet the needs of tissue metabolism levels, the results of alveolar oxygen partial pressure and arterial oxygen partial pressure decreased, while arterial blood carbon dioxide partial pressure increased, but clinically A meaningful hypoventilation syndrome with a PaCO2 generally higher than 6.67 kPa (50 mmHg). basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: non-infectious Complications: pulmonary hypertension
Cause
Causes of alveolar hypoventilation syndrome
(1) Causes of the disease
Many clinical diseases can lead to chronic alveolar hypoventilation, which is common in:
1 Respiratory disease: carotid body dysfunction and trauma, metabolic acidosis,
2 brain stem disease: medullary poliomyelitis, cerebral infarction, new intracranial organisms, demyelinating diseases, long-term application of certain drugs (such as sedatives, anesthetics), primary alveolar hypoventilation syndrome,
3 spinal cord, peripheral nerve and respiratory muscle diseases: polio, motor neuron disease, peripheral neuropathy, myasthenia gravis, muscle atrophy, chronic myopathy,
4 thoracic disease: obesity-hypopnea syndrome, posterior scoliosis, etc.
5 lung and airway diseases: chronic obstructive pulmonary disease, cystic fibrosis, pharyngeal and tracheal obstruction, obstructive sleep apnea syndrome.
(two) pathogenesis
Hypoventilation syndrome, although the underlying causes are inconsistent, but its basic clinical features are similar, that is, due to alveolar hypoventilation caused by elevated PCO2 in alveolar and arterial blood, there is an inverse relationship between alveolar PCO2 and PaO2, alveolar PCO2 The increase will inevitably lead to a decrease in alveolar PO2, resulting in arterial hypoxemia. This typical pathophysiological change occurs during nighttime sleep and is more pronounced when respiratory drive is further reduced.
Prevention
Prevention of alveolar hypoventilation syndrome
Actively prevent and treat lung infections, those with heart failure should correct heart failure. It is not advisable to eat more sweets such as chocolate. The main ingredients of chocolate are fat and sugar, which is high in calories, but the ratio of protein to fat. Do not eat canned drinks and cold drinks. There are many varieties of canned beverages currently on the market. Many beverages are mainly composed of sugar or saccharin, spices, pigments and water, but the nutrition is often insufficient.
Complication
Complications of alveolar hypopnea syndrome Complications pulmonary hypertension
Complicated with pulmonary hypertension, pulmonary heart disease, heart failure.
Symptom
Alveolar hypoventilation syndrome symptoms common symptoms cyanosis edema fatigue
Clinical manifestations have a variety of symptoms and signs of the primary disease, the cause is unknown, called primary alveolar hypoventilation syndrome, depending on the degree of dyspnea, the symptoms are also different, can appear apathy, dizziness, headache, fatigue, Drowsiness, excessive sweating, severe optic disc edema, increased blood pressure, stress ulcers, cyanosis, pulmonary hypertension, pulmonary heart disease.
According to the clinical manifestations and physical examination of the laboratory, it can be diagnosed.
Examine
Examination of alveolar hypoventilation syndrome
Blood gas analysis of arterial oxygen saturation, arterial oxygen partial pressure decreased, and arterial blood carbon dioxide partial pressure, hydrogen ion concentration, bicarbonate concentration, carbon dioxide binding capacity increased, hematocrit increased.
Pulmonary function tests showed restrictive or obstructive ventilatory dysfunction.
Diagnosis
Diagnosis and differential diagnosis of alveolar hypoventilation syndrome
Clinical needs to be differentiated from pulmonary heart disease. Note that combined with the characteristics of the disease and the characteristics of pulmonary heart disease, patients have a history of chronic cough, cough or asthma, gradually appear fatigue, difficulty breathing. Physical examination is a manifestation of emphysema, including barrel chest, percussion in the lungs, excessive unvoiced sound, decreased upper bound of liver dullness, narrowed or even disappeared. The auscultation sound is low, there may be dry and wet rales, the heart sound is light, and sometimes it can only be heard under the xiphoid. The second sound of the pulmonary artery is hyperthyroidized, and there is a significant heart beat under the upper abdomen xiphoid process, which is the main manifestation of the disease involving the heart. The jugular vein may have mild anger, but the venous pressure is not significantly increased.
