無(wu)(wu)(wu)(wu)創(chuang)呼(hu)(hu)(hu)吸(xi)(xi)機(ji)(ji)（Non-InvasiveVentilator，NIV）是一(yi)種通(tong)(tong)過(guo)面(mian)罩(zhao)或鼻(bi)罩(zhao)等(deng)外部接口提供(gong)通(tong)(tong)氣(qi)(qi)支(zhi)持(chi)的(de)(de)(de)，無(wu)(wu)(wu)(wu)需(xu)侵入性(xing)氣(qi)(qi)管(guan)插管(guan)。根據其(qi)工作原(yuan)理、適(shi)(shi)用(yong)(yong)場景及功(gong)(gong)(gong)能(neng)特點，主要可(ke)分為以下幾類：###1.**持(chi)續氣(qi)(qi)道(dao)(dao)正(zheng)(zheng)壓(ya)(ya)通(tong)(tong)氣(qi)(qi)機(ji)(ji)（C）**-**原(yuan)理**：提供(gong)單一(yi)恒(heng)定正(zheng)(zheng)壓(ya)(ya)，在患(huan)者(zhe)(zhe)(zhe)整個呼(hu)(hu)(hu)吸(xi)(xi)周期（吸(xi)(xi)氣(qi)(qi)和呼(hu)(hu)(hu)氣(qi)(qi)）保(bao)(bao)持(chi)氣(qi)(qi)道(dao)(dao)開(kai)放。-**適(shi)(shi)用(yong)(yong)癥(zheng)**：主要用(yong)(yong)于(yu)阻塞性(xing)睡(shui)眠呼(hu)(hu)(hu)吸(xi)(xi)暫停綜合(he)(he)征（OSAHS），也適(shi)(shi)用(yong)(yong)于(yu)輕度呼(hu)(hu)(hu)吸(xi)(xi)衰(shuai)竭或心源(yuan)性(xing)的(de)(de)(de)輔助(zhu)治(zhi)(zhi)療(liao)(liao)。-**特點**：結構(gou)簡單，操作便捷(jie)，適(shi)(shi)合(he)(he)家(jia)庭使用(yong)(yong)，但對(dui)主動(dong)呼(hu)(hu)(hu)吸(xi)(xi)能(neng)力(li)要求(qiu)較(jiao)(jiao)高(gao)(gao)(gao)(gao)(gao)。###2.**雙水平(ping)氣(qi)(qi)道(dao)(dao)正(zheng)(zheng)壓(ya)(ya)通(tong)(tong)氣(qi)(qi)機(ji)(ji)（Bi）**-**原(yuan)理**：提供(gong)兩(liang)個不(bu)同壓(ya)(ya)力(li)水平(ping)——較(jiao)(jiao)高(gao)(gao)(gao)(gao)(gao)的(de)(de)(de)吸(xi)(xi)氣(qi)(qi)相正(zheng)(zheng)壓(ya)(ya)（I）和較(jiao)(jiao)低(di)的(de)(de)(de)呼(hu)(hu)(hu)氣(qi)(qi)相正(zheng)(zheng)壓(ya)(ya)（E），輔助(zhu)患(huan)者(zhe)(zhe)(zhe)完(wan)成呼(hu)(hu)(hu)吸(xi)(xi)周期。-**適(shi)(shi)用(yong)(yong)癥(zheng)**：適(shi)(shi)用(yong)(yong)于(yu)慢性(xing)阻塞性(xing)肺(fei)疾(ji)(ji)病（COPD）、急性(xing)呼(hu)(hu)(hu)吸(xi)(xi)衰(shuai)竭、神經肌肉疾(ji)(ji)病等(deng)需(xu)要較(jiao)(jiao)高(gao)(gao)(gao)(gao)(gao)通(tong)(tong)氣(qi)(qi)支(zhi)持(chi)的(de)(de)(de)患(huan)者(zhe)(zhe)(zhe)。-**亞型(xing)**：-**S模(mo)式**：由(you)患(huan)者(zhe)(zhe)(zhe)自(zi)主觸(chu)發(fa)呼(hu)(hu)(hu)吸(xi)(xi)。-**T模(mo)式**：按預設(she)頻率(lv)強制(zhi)通(tong)(tong)氣(qi)(qi)。-**ST模(mo)式**：結合(he)(he)S和T模(mo)式，確保(bao)(bao)通(tong)(tong)氣(qi)(qi)保(bao)(bao)障。###3.**智(zhi)能(neng)自(zi)適(shi)(shi)應(ying)呼(hu)(hu)(hu)吸(xi)(xi)機(ji)(ji)（Auto-C/Auto-Bi）**-**原(yuan)理**：通(tong)(tong)過(guo)傳感器實時監測(ce)患(huan)者(zhe)(zhe)(zhe)呼(hu)(hu)(hu)吸(xi)(xi)狀(zhuang)態，自(zi)動(dong)調(diao)節壓(ya)(ya)力(li)水平(ping)以匹配需(xu)求(qiu)。-**適(shi)(shi)用(yong)(yong)癥(zheng)**：適(shi)(shi)用(yong)(yong)于(yu)壓(ya)(ya)力(li)需(xu)求(qiu)波(bo)動(dong)較(jiao)(jiao)大的(de)(de)(de)患(huan)者(zhe)(zhe)(zhe)（如體(ti)位變(bian)化(hua)(hua)(hua)導致OSAHS嚴重程(cheng)度變(bian)化(hua)(hua)(hua)）。-**特點**：提高(gao)(gao)(gao)(gao)(gao)治(zhi)(zhi)療(liao)(liao)舒適(shi)(shi)度，飛利浦呼(hu)(hu)(hu)吸(xi)(xi)檢測(ce)儀維修，降低(di)壓(ya)(ya)力(li)過(guo)高(gao)(gao)(gao)(gao)(gao)引起的(de)(de)(de)不(bu)適(shi)(shi)。###4.**便攜(xie)式旅行呼(hu)(hu)(hu)吸(xi)(xi)機(ji)(ji)**-**設(she)計**：輕量化(hua)(hua)(hua)、小型(xing)化(hua)(hua)(hua)，內置電池支(zhi)持(chi)移動(dong)使用(yong)(yong)。-**適(shi)(shi)用(yong)(yong)場景**：需(xu)長期通(tong)(tong)氣(qi)(qi)的(de)(de)(de)患(huan)者(zhe)(zhe)(zhe)出行或緊急轉(zhuan)運。-**功(gong)(gong)(gong)能(neng)**：通(tong)(tong)常集(ji)成基礎C/Bi模(mo)式，兼(jian)顧續航與便攜(xie)性(xing)。###5.**高(gao)(gao)(gao)(gao)(gao)流(liu)(liu)量氧療(liao)(liao)設(she)備（HFNC）**-**原(yuan)理**：通(tong)(tong)過(guo)高(gao)(gao)(gao)(gao)(gao)流(liu)(liu)量加溫濕化(hua)(hua)(hua)氧氣(qi)(qi)提供(gong)一(yi)定水平(ping)的(de)(de)(de)氣(qi)(qi)道(dao)(dao)正(zheng)(zheng)壓(ya)(ya)，兼(jian)具氧濃度調(diao)節功(gong)(gong)(gong)能(neng)。-**適(shi)(shi)用(yong)(yong)癥(zheng)**：輕中(zhong)度呼(hu)(hu)(hu)吸(xi)(xi)衰(shuai)竭、拔管(guan)后過(guo)渡支(zhi)持(chi)或拒絕面(mian)罩(zhao)通(tong)(tong)氣(qi)(qi)的(de)(de)(de)患(huan)者(zhe)(zhe)(zhe)。###6.**新(xin)生(sheng)兒(er)/兒(er)童無(wu)(wu)(wu)(wu)創(chuang)呼(hu)(hu)(hu)吸(xi)(xi)機(ji)(ji)**-**特點**：壓(ya)(ya)力(li)范圍(wei)、面(mian)罩(zhao)尺寸(cun)及算法(fa)針(zhen)對(dui)嬰幼(you)兒(er)生(sheng)理特點優(you)化(hua)(hua)(hua)，具備更靈敏的(de)(de)(de)觸(chu)發(fa)系統(tong)和安全保(bao)(bao)護機(ji)(ji)制(zhi)。###7.**多功(gong)(gong)(gong)能(neng)無(wu)(wu)(wu)(wu)創(chuang)呼(hu)(hu)(hu)吸(xi)(xi)機(ji)(ji)**-**應(ying)用(yong)(yong)場景**：醫(yi)院(yuan)ICU或急診(zhen)科，可(ke)提供(gong)通(tong)(tong)氣(qi)(qi)模(mo)式（如AVAPS、iVAPS），集(ji)成監測(ce)報(bao)警(jing)系統(tong)，兼(jian)容(rong)有(you)創(chuang)-無(wu)(wu)(wu)(wu)創(chuang)切換(huan)。###總結無(wu)(wu)(wu)(wu)創(chuang)呼(hu)(hu)(hu)吸(xi)(xi)機(ji)(ji)的(de)(de)(de)選擇需(xu)結合(he)(he)患(huan)者(zhe)(zhe)(zhe)疾(ji)(ji)病類型(xing)、呼(hu)(hu)(hu)吸(xi)(xi)功(gong)(gong)(gong)能(neng)狀(zhuang)態及使用(yong)(yong)環(huan)境(jing)。C側(ce)重維持(chi)氣(qi)(qi)道(dao)(dao)開(kai)放，Bi提供(gong)雙向(xiang)壓(ya)(ya)力(li)支(zhi)持(chi)，智(zhi)能(neng)機(ji)(ji)型(xing)提升個性(xing)化(hua)(hua)(hua)治(zhi)(zhi)療(liao)(liao)體(ti)驗，而便攜(xie)式和高(gao)(gao)(gao)(gao)(gao)流(liu)(liu)量設(she)備則拓(tuo)展了臨床應(ying)用(yong)(yong)場景。隨著技(ji)術進步(bu)，遠程(cheng)監測(ce)、云數據管(guan)理等(deng)功(gong)(gong)(gong)能(neng)的(de)(de)(de)加入進一(yi)步(bu)優(you)化(hua)(hua)(hua)了長期家(jia)庭治(zhi)(zhi)療(liao)(liao)的(de)(de)(de)安全性(xing)。

瑞思邁呼(hu)(hu)吸機(ji)(ji)（ResMed呼(hu)(hu)吸機(ji)(ji)）是用(yong)(yong)于(yu)治(zhi)療(liao)睡眠(mian)呼(hu)(hu)吸暫停、慢性(xing)(xing)呼(hu)(hu)吸衰竭等疾病的常(chang)用(yong)(yong)。為確(que)保(bao)(bao)安全(quan)有效(xiao)使(shi)(shi)用(yong)(yong)，需(xu)(xu)(xu)(xu)注意(yi)(yi)以下(xia)事項：###一、使(shi)(shi)用(yong)(yong)前準備(bei)1.**調(diao)試(shi)**：使(shi)(shi)用(yong)(yong)需(xu)(xu)(xu)(xu)由醫(yi)生或(huo)(huo)技(ji)術人員設定壓(ya)(ya)力參(can)數，避免自行調(diao)整。參(can)數不當可能(neng)導致治(zhi)果差或(huo)(huo)引發不適。2.**佩戴檢查**：選擇合(he)(he)適尺(chi)寸的面(mian)(mian)罩(zhao)(zhao)，確(que)保(bao)(bao)貼合(he)(he)面(mian)(mian)部(bu)不漏(lou)(lou)氣(qi)。鼻罩(zhao)(zhao)/口鼻罩(zhao)(zhao)需(xu)(xu)(xu)(xu)調(diao)整頭(tou)(tou)帶松緊度(du)，石(shi)獅(shi)呼(hu)(hu)吸檢測(ce)儀維(wei)修(xiu)，以插入1-2指為宜。###二(er)、日(ri)常(chang)使(shi)(shi)用(yong)(yong)規范1.**清(qing)潔(jie)維(wei)護**：-每(mei)日(ri)用(yong)(yong)中(zhong)性(xing)(xing)清(qing)潔(jie)劑清(qing)洗(xi)面(mian)(mian)罩(zhao)(zhao)、管(guan)路，避免酒(jiu)精擦拭硅膠部(bu)件(jian)。-每(mei)周用(yong)(yong)浸泡管(guan)路30分鐘，晾(liang)干(gan)防霉變。-每(mei)月(yue)更(geng)換(huan)過濾棉，潮(chao)濕(shi)環(huan)(huan)境需(xu)(xu)(xu)(xu)縮短更(geng)換(huan)周期(qi)(qi)。2.**濕(shi)化(hua)器(qi)管(guan)理**：使(shi)(shi)用(yong)(yong)純凈水或(huo)(huo)蒸餾水，每(mei)日(ri)更(geng)換(huan)避免滋生細(xi)菌(jun)。水位勿超MA，關機(ji)(ji)后倒(dao)空剩余水。3.**環(huan)(huan)境要求**：保(bao)(bao)持室溫(wen)18-28℃，濕(shi)度(du)40-60%。避免高(gao)溫(wen)、粉塵環(huan)(huan)境，遠離加濕(shi)器(qi)直接噴霧(wu)。###三、安全(quan)注意(yi)(yi)事項1.**電(dian)(dian)(dian)源(yuan)管(guan)理**：使(shi)(shi)用(yong)(yong)原裝電(dian)(dian)(dian)源(yuan)適配器(qi)，長(chang)(chang)期(qi)(qi)不用(yong)(yong)時(shi)斷開電(dian)(dian)(dian)源(yuan)。備(bei)用(yong)(yong)電(dian)(dian)(dian)池需(xu)(xu)(xu)(xu)每(mei)月(yue)充放電(dian)(dian)(dian)維(wei)護。2.**異常(chang)處理**：出現(xian)(xian)持續漏(lou)(lou)氣(qi)、異常(chang)噪(zao)音(yin)或(huo)(huo)呼(hu)(hu)吸受(shou)阻時(shi)，立(li)即停機(ji)(ji)檢查。故障代碼需(xu)(xu)(xu)(xu)聯系售后（如Err01表(biao)示傳(chuan)感器(qi)異常(chang)）。3.**禁(jin)忌情況**：、顱(lu)腦外傷急性(xing)(xing)期(qi)(qi)、嚴(yan)重肺(fei)大泡患者禁(jin)用(yong)(yong)。使(shi)(shi)用(yong)(yong)中(zhong)出現(xian)(xian)胸痛、眩暈需(xu)(xu)(xu)(xu)即刻就(jiu)醫(yi)。###四、長(chang)(chang)期(qi)(qi)使(shi)(shi)用(yong)(yong)建(jian)議1.每(mei)3個月(yue)更(geng)換(huan)硅膠面(mian)(mian)罩(zhao)(zhao)墊(dian)，每(mei)6個月(yue)更(geng)換(huan)管(guan)路和(he)頭(tou)(tou)帶。2.每(mei)半(ban)年(nian)返廠校準壓(ya)(ya)力傳(chuan)感器(qi)，每(mei)年(nian)更(geng)換(huan)主機(ji)(ji)過濾棉。3.治(zhi)療(liao)期(qi)(qi)間(jian)定期(qi)(qi)復查血氧飽和(he)度(du)及睡眠(mian)監測(ce)，評估(gu)。>**特(te)別提示**：呼(hu)(hu)吸機(ji)(ji)屬二(er)類，需(xu)(xu)(xu)(xu)配合(he)(he)醫(yi)生治(zhi)療(liao)方案使(shi)(shi)用(yong)(yong)。旅行時(shi)隨身(shen)攜帶醫(yi)療(liao)證(zheng)明，過安檢時(shi)主動(dong)申報(bao)設備(bei)。遵循上述注意(yi)(yi)事項可延(yan)長(chang)(chang)設備(bei)壽命（通常(chang)5-8年(nian)），并(bing)確(que)保(bao)(bao)治(zhi)果。數據顯示規范維(wei)護可使(shi)(shi)風(feng)險降低67%，治(zhi)療(liao)依(yi)從性(xing)(xing)提高(gao)42%（ResMed2022臨(lin)床報(bao)告(gao)）。

家(jia)用(yong)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)機(ji)主(zhu)要分(fen)(fen)為兩大(da)類(lei)：治療(liao)(liao)(liao)睡(shui)眠(mian)(mian)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)障礙(ai)的(de)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)機(ji)（如(ru)C、AutoC、Bi）和(he)輔助治療(liao)(liao)(liao)慢性呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)系統疾(ji)病的(de)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)機(ji)（如(ru)雙水(shui)平ST模式(shi)(shi)(shi)、AVAPS等）。以下(xia)是常見類(lei)別及(ji)特點：###一(yi)、睡(shui)眠(mian)(mian)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)機(ji)1.**C（持續正壓(ya)(ya)(ya)(ya)通(tong)氣(qi)(qi)(qi)）**通(tong)過恒定壓(ya)(ya)(ya)(ya)力(li)撐(cheng)開上(shang)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)道，適(shi)(shi)(shi)用(yong)于(yu)(yu)單純(chun)阻(zu)塞(sai)性睡(shui)眠(mian)(mian)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)暫停(ting)（OSA）患(huan)者(zhe)(zhe)。機(ji)型(xing)輕便，價格(ge)較低（約2000-5000元(yuan)），但壓(ya)(ya)(ya)(ya)力(li)固(gu)定，舒(shu)適(shi)(shi)(shi)性一(yi)般。2.**AutoC（自動(dong)調(diao)壓(ya)(ya)(ya)(ya)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)機(ji)）**可實(shi)時監測呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)狀態并自動(dong)調(diao)節壓(ya)(ya)(ya)(ya)力(li)，適(shi)(shi)(shi)應夜間不(bu)同(tong)階段的(de)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)需求(qiu)。適(shi)(shi)(shi)合壓(ya)(ya)(ya)(ya)力(li)需求(qiu)波動(dong)大(da)的(de)患(huan)者(zhe)(zhe)，價格(ge)在4000-8000元(yuan)之間。3.**Bi（雙水(shui)平正壓(ya)(ya)(ya)(ya)通(tong)氣(qi)(qi)(qi)）**提供吸(xi)(xi)(xi)(xi)(xi)(xi)氣(qi)(qi)(qi)壓(ya)(ya)(ya)(ya)（I）和(he)呼(hu)(hu)氣(qi)(qi)(qi)壓(ya)(ya)(ya)(ya)（E）雙壓(ya)(ya)(ya)(ya)力(li)支持，降低呼(hu)(hu)氣(qi)(qi)(qi)阻(zu)力(li)。適(shi)(shi)(shi)用(yong)于(yu)(yu)中重度(du)OSA或合并患(huan)者(zhe)(zhe)，價格(ge)約6000-12000元(yuan)。###二、治療(liao)(liao)(liao)型(xing)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)機(ji)1.**雙水(shui)平ST模式(shi)(shi)(shi)**在Bi基礎上(shang)增加(jia)備用(yong)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)頻率，可輔助呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)肌無力(li)患(huan)者(zhe)(zhe)（如(ru)漸凍人、脊髓損傷(shang)）。具備時間控制（T模式(shi)(shi)(shi)）和(he)自主(zhu)觸(chu)發（S模式(shi)(shi)(shi)），價格(ge)1.5萬(wan)-3萬(wan)元(yuan)。2.**AVAPS（平均容(rong)積保證壓(ya)(ya)(ya)(ya)力(li)支持）**自動(dong)調(diao)節壓(ya)(ya)(ya)(ya)力(li)以維持目標潮氣(qi)(qi)(qi)量，適(shi)(shi)(shi)用(yong)于(yu)(yu)慢性阻(zu)塞(sai)性（COPD）、神經肌肉疾(ji)病等，家(jia)用(yong)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)檢測儀維修，價格(ge)2萬(wan)-4萬(wan)元(yuan)。3.**便攜式(shi)(shi)(shi)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)機(ji)**內(nei)置電池，重量＜2kg，適(shi)(shi)(shi)合出行使用(yong)。部分(fen)(fen)機(ji)型(xing)兼容(rong)氧療(liao)(liao)(liao)接口，滿(man)足(zu)移動(dong)醫(yi)療(liao)(liao)(liao)需求(qiu)。###三、選(xuan)擇(ze)要點-**明確(que)需求(qiu)**：睡(shui)眠(mian)(mian)呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)暫停(ting)C/AutoC，慢性呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)衰竭需級BiST或AVAPS。-**舒(shu)適(shi)(shi)(shi)配(pei)置**：加(jia)溫加(jia)濕(shi)器、智能降噪（＜30分(fen)(fen)貝）、面罩適(shi)(shi)(shi)配(pei)性。-**數據管理**：APP同(tong)步睡(shui)眠(mian)(mian)報告，便于(yu)(yu)醫(yi)生調(diao)整參數。-**品(pin)牌與售后**：瑞(rui)思邁、飛利浦、萬(wan)曼等品(pin)牌提供的(de)技術支持。特殊人群(qun)（如(ru)兒(er)童、肥胖患(huan)者(zhe)(zhe)）需選(xuan)擇(ze)壓(ya)(ya)(ya)(ya)力(li)范(fan)圍更大(da)的(de)機(ji)型(xing)。建議在呼(hu)(hu)吸(xi)(xi)(xi)(xi)(xi)(xi)科醫(yi)生指導(dao)下(xia)，通(tong)過多導(dao)睡(shui)眠(mian)(mian)監測（PSG）或肺功能檢查后選(xuan)購。