打鼾呼(hu)(hu)(hu)(hu)吸(xi)機(ji)(ji)（C呼(hu)(hu)(hu)(hu)吸(xi)機(ji)(ji)）知識概(gai)述(shu)打鼾呼(hu)(hu)(hu)(hu)吸(xi)機(ji)(ji)是治療(liao)阻塞性(xing)睡(shui)(shui)眠(mian)呼(hu)(hu)(hu)(hu)吸(xi)暫(zan)停(ting)(ting)低(di)(di)通(tong)(tong)氣(qi)綜合(he)(he)征（OSAHS）的(de)，通(tong)(tong)過(guo)(guo)持續氣(qi)道正(zheng)(zheng)壓(ya)通(tong)(tong)氣(qi)改(gai)善夜間(jian)呼(hu)(hu)(hu)(hu)吸(xi)功能(neng)(neng)。其(qi)(qi)原(yuan)理是通(tong)(tong)過(guo)(guo)面罩向患者(zhe)氣(qi)道輸送穩定(ding)氣(qi)流壓(ya)力，防止睡(shui)(shui)眠(mian)時(shi)咽喉部(bu)軟(ruan)組(zu)織塌(ta)陷導致(zhi)的(de)呼(hu)(hu)(hu)(hu)吸(xi)暫(zan)停(ting)(ting)和(he)低(di)(di)通(tong)(tong)氣(qi)。主要類(lei)型(xing)：1.固定(ding)壓(ya)力型(xing)（C）：預設單一(yi)壓(ya)力值，經濟(ji)實(shi)用但(dan)需(xu)(xu)調(diao)(diao)試；2.自動(dong)調(diao)(diao)壓(ya)型(xing)（A）：實(shi)時(shi)監測呼(hu)(hu)(hu)(hu)吸(xi)動(dong)態，智(zhi)能(neng)(neng)調(diao)(diao)節壓(ya)力范(fan)圍；3.雙(shuang)水(shui)(shui)(shui)平(ping)型(xing)（Bi）：提(ti)供吸(xi)/呼(hu)(hu)(hu)(hu)不同壓(ya)力，適(shi)合(he)(he)心肺功能(neng)(neng)異常(chang)患者(zhe)。適(shi)用人(ren)群：-中(zhong)重(zhong)度(du)睡(shui)(shui)眠(mian)呼(hu)(hu)(hu)(hu)吸(xi)暫(zan)停(ting)(ting)患者(zhe)（AHI≥15次/小時(shi)）-伴隨日(ri)間(jian)嗜睡(shui)(shui)、等人(ren)群-術后恢復或無法耐受其(qi)(qi)他治療(liao)方式(shi)(shi)者(zhe)使(shi)(shi)(shi)用注意事項：?需(xu)(xu)經睡(shui)(shui)眠(mian)監測和(he)壓(ya)力滴定(ding)確定(ding)治療(liao)方案(an)?初始使(shi)(shi)(shi)用需(xu)(xu)1-2周適(shi)應期，建議(yi)從低(di)(di)壓(ya)力逐步調(diao)(diao)整(zheng)?面罩選擇(ze)需(xu)(xu)兼顧(gu)密封性(xing)和(he)舒適(shi)度(du)（鼻罩/口鼻罩/鼻枕）?配(pei)合(he)(he)濕化器使(shi)(shi)(shi)用可緩(huan)(huan)解(jie)鼻腔(qiang)干(gan)燥等不適(shi)日(ri)常(chang)維護(hu)：每日(ri)清潔面罩和(he)管(guan)路，每周消毒水(shui)(shui)(shui)箱，每月(yue)更換過(guo)(guo)濾棉。建議(yi)每年(nian)返廠檢(jian)測壓(ya)力精度(du)，及時(shi)更換老化部(bu)件。臨床(chuang)數(shu)據顯(xian)示規范(fan)使(shi)(shi)(shi)用可降低(di)(di)事件風險40%以上，改(gai)善血氧飽和(he)度(du)至正(zheng)(zheng)常(chang)水(shui)(shui)(shui)平(ping)（＞90%）達95%。副作(zuo)用管(guan)理：約30%使(shi)(shi)(shi)用者(zhe)初期出現鼻干(gan)、皮(pi)膚壓(ya)痕(hen)，可通(tong)(tong)過(guo)(guo)調(diao)(diao)節濕化溫(wen)度(du)、使(shi)(shi)(shi)用皮(pi)膚保(bao)護(hu)貼(tie)緩(huan)(huan)解(jie)。需(xu)(xu)注意，呼(hu)(hu)(hu)(hu)吸(xi)機(ji)(ji)治療(liao)需(xu)(xu)配(pei)合(he)(he)減重(zhong)、側臥睡(shui)(shui)姿等生活(huo)方式(shi)(shi)干(gan)預，重(zhong)度(du)患者(zhe)可能(neng)(neng)需(xu)(xu)要聯合(he)(he)口腔(qiang)矯正(zheng)(zheng)器或手術治療(liao)。建議(yi)每6-12個月(yue)復診(zhen)評估。

瑞(rui)(rui)思邁呼(hu)吸機(ji)(ji)（ResMed呼(hu)吸機(ji)(ji)）是用(yong)(yong)(yong)(yong)于治(zhi)療睡眠(mian)呼(hu)吸暫停、慢性(xing)呼(hu)吸衰竭等疾病的常(chang)用(yong)(yong)(yong)(yong)。為確保(bao)(bao)安全(quan)(quan)有效使(shi)(shi)用(yong)(yong)(yong)(yong)，需(xu)(xu)注意(yi)以(yi)下事項(xiang)(xiang)：###一、使(shi)(shi)用(yong)(yong)(yong)(yong)前準備1.**調試**：使(shi)(shi)用(yong)(yong)(yong)(yong)需(xu)(xu)由醫(yi)生(sheng)或技術(shu)人員設(she)定壓(ya)力參(can)數，避(bi)免自行(xing)(xing)調整。參(can)數不(bu)(bu)當(dang)可能導致(zhi)治(zhi)果差或引發不(bu)(bu)適(shi)。2.**佩戴檢(jian)(jian)查(cha)**：選擇(ze)合適(shi)尺(chi)寸的面(mian)罩(zhao)，確保(bao)(bao)貼合面(mian)部(bu)不(bu)(bu)漏氣(qi)。鼻罩(zhao)/口鼻罩(zhao)需(xu)(xu)調整頭(tou)帶松緊度(du)，以(yi)插入(ru)1-2指為宜。###二(er)、日常(chang)使(shi)(shi)用(yong)(yong)(yong)(yong)規范(fan)1.**清(qing)(qing)潔(jie)維護(hu)(hu)**：-每(mei)(mei)日用(yong)(yong)(yong)(yong)中(zhong)性(xing)清(qing)(qing)潔(jie)劑清(qing)(qing)洗面(mian)罩(zhao)、管路，避(bi)免酒精擦拭硅膠部(bu)件。-每(mei)(mei)周用(yong)(yong)(yong)(yong)浸泡管路30分鐘，晾干(gan)防霉變。-每(mei)(mei)月更換(huan)(huan)過濾(lv)棉(mian)，潮濕(shi)(shi)環境需(xu)(xu)縮短(duan)更換(huan)(huan)周期(qi)(qi)(qi)。2.**濕(shi)(shi)化器(qi)管理**：使(shi)(shi)用(yong)(yong)(yong)(yong)純凈(jing)水或蒸餾水，每(mei)(mei)日更換(huan)(huan)避(bi)免滋生(sheng)細菌(jun)。水位(wei)勿超MA，關(guan)機(ji)(ji)后倒空剩(sheng)余水。3.**環境要(yao)求(qiu)**：保(bao)(bao)持室溫(wen)18-28℃，濕(shi)(shi)度(du)40-60%。避(bi)免高溫(wen)、粉塵(chen)環境，贛(gan)州呼(hu)吸機(ji)(ji)，遠離加濕(shi)(shi)器(qi)直接噴霧。###三、安全(quan)(quan)注意(yi)事項(xiang)(xiang)1.**電(dian)源(yuan)(yuan)管理**：使(shi)(shi)用(yong)(yong)(yong)(yong)原(yuan)裝電(dian)源(yuan)(yuan)適(shi)配器(qi)，長期(qi)(qi)(qi)不(bu)(bu)用(yong)(yong)(yong)(yong)時斷開電(dian)源(yuan)(yuan)。備用(yong)(yong)(yong)(yong)電(dian)池需(xu)(xu)每(mei)(mei)月充放電(dian)維護(hu)(hu)。2.**異(yi)常(chang)處理**：出(chu)現持續漏氣(qi)、異(yi)常(chang)噪音(yin)或呼(hu)吸受阻時，立(li)即停機(ji)(ji)檢(jian)(jian)查(cha)。故障代碼需(xu)(xu)聯系售后（如Err01表(biao)示傳感(gan)器(qi)異(yi)常(chang)）。3.**禁(jin)忌情(qing)況(kuang)**：、顱腦外傷急性(xing)期(qi)(qi)(qi)、嚴重肺大泡患者禁(jin)用(yong)(yong)(yong)(yong)。使(shi)(shi)用(yong)(yong)(yong)(yong)中(zhong)出(chu)現胸(xiong)痛、眩暈需(xu)(xu)即刻就醫(yi)。###四、長期(qi)(qi)(qi)使(shi)(shi)用(yong)(yong)(yong)(yong)建(jian)議1.每(mei)(mei)3個月更換(huan)(huan)硅膠面(mian)罩(zhao)墊，每(mei)(mei)6個月更換(huan)(huan)管路和(he)頭(tou)帶。2.每(mei)(mei)半年(nian)返廠校準壓(ya)力傳感(gan)器(qi)，每(mei)(mei)年(nian)更換(huan)(huan)主機(ji)(ji)過濾(lv)棉(mian)。3.治(zhi)療期(qi)(qi)(qi)間定期(qi)(qi)(qi)復查(cha)血氧飽(bao)和(he)度(du)及睡眠(mian)監(jian)測(ce)，評(ping)估。>**特別提示**：呼(hu)吸機(ji)(ji)屬二(er)類(lei)，需(xu)(xu)配合醫(yi)生(sheng)治(zhi)療方(fang)案使(shi)(shi)用(yong)(yong)(yong)(yong)。旅行(xing)(xing)時隨身攜(xie)帶醫(yi)療證明(ming)，瑞(rui)(rui)思邁呼(hu)吸機(ji)(ji)代理商，過安檢(jian)(jian)時主動申報設(she)備。遵循上述注意(yi)事項(xiang)(xiang)可延長設(she)備壽(shou)命（通常(chang)5-8年(nian)），并確保(bao)(bao)治(zhi)果。數據顯示規范(fan)維護(hu)(hu)可使(shi)(shi)風險降低67%，治(zhi)療依從性(xing)提高42%（ResMed2022臨床報告(gao)）。

老年(nian)人呼(hu)吸(xi)(xi)機(ji)安(an)(an)裝使(shi)用(yong)(yong)(yong)(yong)指南（約450字）一(yi)、準(zhun)備(bei)工(gong)作1.開箱(xiang)檢(jian)查(cha)：核(he)對主機(ji)、管(guan)(guan)路(lu)、面(mian)(mian)罩(zhao)（鼻罩(zhao)/口鼻罩(zhao)）、濕(shi)(shi)化器(qi)、電源(yuan)適(shi)配器(qi)等(deng)配件是(shi)否(fou)(fou)齊全，確認設(she)(she)備(bei)無運輸損傷2.環境要(yao)求：選(xuan)擇通風良好、電源(yuan)穩定(ding)（建議配置(zhi)UPS電源(yuan)）、距離床頭30-50cm的穩固臺面(mian)(mian)3.清(qing)(qing)潔消(xiao)毒：使(shi)用(yong)(yong)(yong)(yong)前用(yong)(yong)(yong)(yong)75%酒精(jing)擦拭面(mian)(mian)罩(zhao)接觸部(bu)位，管(guan)(guan)路(lu)需消(xiao)毒液浸泡30分(fen)鐘后(hou)晾干二、安(an)(an)裝步驟(zou)1.組裝主機(ji)：連接濕(shi)(shi)化器(qi)與(yu)主機(ji)，瑞思邁(mai)呼(hu)吸(xi)(xi)機(ji)專賣(mai)店，注入(ru)蒸(zheng)餾水(shui)至(zhi)(zhi)MA（建議每日(ri)更(geng)(geng)(geng)換）2.管(guan)(guan)路(lu)連接：將(jiang)波紋管(guan)(guan)一(yi)端接入(ru)濕(shi)(shi)化器(qi)出(chu)口，另(ling)一(yi)端連接面(mian)(mian)罩(zhao)接口3.佩戴(dai)調(diao)節(jie)：-選(xuan)擇合(he)適(shi)尺(chi)寸面(mian)(mian)罩(zhao)（需測(ce)(ce)量鼻梁(liang)到(dao)唇溝(gou)距離）-先戴(dai)頭帶后(hou)扣面(mian)(mian)罩(zhao)，調(diao)節(jie)松緊(jin)至(zhi)(zhi)可插(cha)入(ru)1指為宜-檢(jian)查(cha)密封性(xing)：開機(ji)后(hou)手觸面(mian)(mian)部(bu)無漏氣(qi)感三(san)、參(can)數(shu)(shu)設(she)(she)置(zhi)1.模式(shi)選(xuan)擇：C（持續正(zheng)壓(ya)(ya)(ya)）或Bi（雙(shuang)水(shui)平）模式(shi)需遵(zun)醫囑(zhu)2.壓(ya)(ya)(ya)力調(diao)節(jie)：初始壓(ya)(ya)(ya)力通常(chang)4-6cmH?O，治療(liao)(liao)壓(ya)(ya)(ya)力由醫生根據(ju)血氧監(jian)測(ce)(ce)確定(ding)3.溫濕(shi)(shi)設(she)(she)置(zhi)：濕(shi)(shi)化器(qi)溫度建議保(bao)持2-3檔（室(shi)溫＜18℃時適(shi)當調(diao)高）四、使(shi)用(yong)(yong)(yong)(yong)測(ce)(ce)試1.開機(ji)自檢(jian)：觀察設(she)(she)備(bei)是(shi)否(fou)(fou)正(zheng)常(chang)啟動，報(bao)警功能是(shi)否(fou)(fou)靈敏2.試運行(xing)檢(jian)測(ce)(ce)：佩戴(dai)后(hou)正(zheng)常(chang)呼(hu)吸(xi)(xi)5分(fen)鐘，確認：-壓(ya)(ya)(ya)力表波動范圍＜2cmH?O-血氧飽和度提(ti)(ti)升(sheng)至(zhi)(zhi)95%以(yi)上(shang)-無明顯胸(xiong)悶、耳(er)脹等(deng)不適(shi)五、注意事項(xiang)1.每日(ri)清(qing)(qing)潔：面(mian)(mian)罩(zhao)硅膠墊用(yong)(yong)(yong)(yong)中性(xing)洗滌劑(ji)清(qing)(qing)洗，管(guan)(guan)路(lu)每周消(xiao)毒1次2.耗材更(geng)(geng)(geng)換：濾(lv)棉(mian)每2月更(geng)(geng)(geng)換，瑞思邁(mai)呼(hu)吸(xi)(xi)機(ji)保(bao)養，細(xi)菌(jun)過濾(lv)器(qi)每半年(nian)更(geng)(geng)(geng)換3.應急處理：突發停電立即(ji)摘下面(mian)(mian)罩(zhao)，備(bei)用(yong)(yong)(yong)(yong)氧氣(qi)袋過渡4.定(ding)期維護：每季度檢(jian)測(ce)(ce)壓(ya)(ya)(ya)力精(jing)度，每年(nian)返廠校(xiao)準(zhun)提(ti)(ti)示：安(an)(an)裝建議由呼(hu)吸(xi)(xi)治療(liao)(liao)師指導，使(shi)用(yong)(yong)(yong)(yong)前需進行(xing)肺(fei)功能評估，治療(liao)(liao)期間(jian)應配合(he)血氧監(jian)測(ce)(ce)，出(chu)現、等(deng)癥狀(zhuang)應及時就醫調(diao)整參(can)數(shu)(shu)。