**家(jia)用(yong)(yong)呼(hu)吸機(ji)使(shi)(shi)用(yong)(yong)注意事項(xiang)****1.正(zheng)確(que)(que)安裝與(yu)調試(shi)**?使(shi)(shi)用(yong)(yong)前，需(xu)(xu)由醫護人員指導安裝，確(que)(que)保(bao)呼(hu)吸機(ji)、管(guan)(guan)路、面(mian)(mian)罩(zhao)(zhao)(zhao)連(lian)接(jie)緊密，避免漏(lou)氣。?根據醫囑調整(zheng)壓(ya)力(li)參數(shu)（如(ru)(ru)C、Bi模式(shi)），**切勿自行(xing)更改設置(zhi)**，以免影(ying)(ying)響治果或(huo)(huo)引(yin)發(fa)(fa)不適。**2.日常清潔(jie)與(yu)消(xiao)毒(du)**?**面(mian)(mian)罩(zhao)(zhao)(zhao)、管(guan)(guan)路、濕(shi)(shi)化(hua)器水(shui)(shui)箱**需(xu)(xu)每(mei)日用(yong)(yong)中(zhong)性清潔(jie)劑清洗，每(mei)周用(yong)(yong)消(xiao)毒(du)液浸泡30分鐘，自然晾干(gan)(gan)，避免暴曬。?過(guo)濾棉需(xu)(xu)每(mei)周清潔(jie)或(huo)(huo)按說明書(shu)更換(huan)，防止灰塵堵塞影(ying)(ying)響通氣效率(lv)。**3.規范使(shi)(shi)用(yong)(yong)習(xi)慣**?使(shi)(shi)用(yong)(yong)前檢查電源穩(wen)定性，避免電壓(ya)不穩(wen)導致設備故障，建議配備備用(yong)(yong)電源（如(ru)(ru)UPS）應對突發(fa)(fa)停(ting)電。?佩(pei)戴面(mian)(mian)罩(zhao)(zhao)(zhao)時需(xu)(xu)調整(zheng)頭帶松緊度，確(que)(que)保(bao)貼(tie)合(he)面(mian)(mian)部但不過(guo)緊，避免壓(ya)傷皮膚(fu)或(huo)(huo)漏(lou)氣。若(ruo)出現鼻(bi)干(gan)(gan)、眼澀，可(ke)開啟濕(shi)(shi)化(hua)器并調節濕(shi)(shi)度檔位。?使(shi)(shi)用(yong)(yong)中(zhong)若(ruo)出現胸悶(men)、頭暈等不適，應立即停(ting)機(ji)并聯(lian)系醫生(sheng)。**4.定期(qi)維護與(yu)隨訪**?每(mei)3個月更換(huan)過(guo)濾棉、管(guan)(guan)路等易損配件，面(mian)(mian)罩(zhao)(zhao)(zhao)硅膠墊每(mei)6-12個月更換(huan)一次。?每(mei)月檢查主(zhu)機(ji)運行(xing)狀態，觀察是否有異常噪音(yin)或(huo)(huo)報警(jing)提(ti)示。?**至少(shao)每(mei)半年復診一次**，由醫生(sheng)評估(gu)治果并調整(zheng)參數(shu)。**5.環(huan)境(jing)與(yu)安全要求**?保(bao)持設備遠(yuan)離(li)高(gao)溫(wen)、潮濕(shi)(shi)環(huan)境(jing)，避免陽光(guang)直(zhi)射。?使(shi)(shi)用(yong)(yong)期(qi)間(jian)禁止吸煙、遠(yuan)離(li)明火，防止氧氣富集引(yin)發(fa)(fa)風險。?濕(shi)(shi)化(hua)器加(jia)水(shui)(shui)需(xu)(xu)使(shi)(shi)用(yong)(yong)純凈水(shui)(shui)或(huo)(huo)蒸餾水(shui)(shui)，減少(shao)水(shui)(shui)垢沉積。**提(ti)示**：長期(qi)使(shi)(shi)用(yong)(yong)呼(hu)吸機(ji)可(ke)能產生(sheng)依(yi)賴(lai)感，需(xu)(xu)配合(he)健康管(guan)(guan)理(li)（如(ru)(ru)減重、戒煙酒(jiu)）提(ti)升。若(ruo)設備頻繁(fan)報警(jing)或(huo)(huo)治果下降，應及時聯(lian)系售后或(huo)(huo)機(ji)構檢修(xiu)。

無創呼(hu)(hu)吸機(ji)(ji)的正確(que)安裝(zhuang)(zhuang)是(shi)確(que)保(bao)治(zhi)果和(he)安全(quan)(quan)使(shi)(shi)用(yong)的關鍵(jian)。以下(xia)(xia)是(shi)標(biao)準(zhun)安裝(zhuang)(zhuang)流程(cheng)及(ji)(ji)注(zhu)意事項：一、設(she)備(bei)(bei)準(zhun)備(bei)(bei)1.開(kai)(kai)(kai)箱檢(jian)查(cha)主機(ji)(ji)、管(guan)路、濕(shi)化罐(guan)（若配備(bei)(bei)）、鼻/面(mian)(mian)(mian)(mian)罩(zhao)、頭(tou)(tou)(tou)帶(dai)、過濾(lv)(lv)棉(mian)等配件是(shi)否(fou)(fou)齊全(quan)(quan)2.確(que)認電(dian)(dian)源(yuan)電(dian)(dian)壓(ya)與(yu)設(she)備(bei)(bei)要求匹(pi)配（通(tong)常220V±10%），建(jian)(jian)議使(shi)(shi)用(yong)穩(wen)壓(ya)電(dian)(dian)源(yuan)3.連(lian)(lian)接(jie)(jie)(jie)(jie)設(she)備(bei)(bei)至電(dian)(dian)源(yuan)插座(zuo)，避免(mian)與(yu)其他(ta)大功率電(dian)(dian)器(qi)共用(yong)二、管(guan)路連(lian)(lian)接(jie)(jie)(jie)(jie)1.將呼(hu)(hu)吸管(guan)路正確(que)連(lian)(lian)接(jie)(jie)(jie)(jie)主機(ji)(ji)出氣口(kou)（箭頭(tou)(tou)(tou)方向朝向患(huan)者(zhe)端）2.若使(shi)(shi)用(yong)濕(shi)化器(qi)：-注(zhu)入滅菌蒸餾水(shui)至MAX刻度線下(xia)(xia)（建(jian)(jian)議每(mei)(mei)(mei)(mei)天更(geng)(geng)換(huan)）-連(lian)(lian)接(jie)(jie)(jie)(jie)濕(shi)化罐(guan)與(yu)主機(ji)(ji)，確(que)保(bao)密(mi)封圈完好3.安裝(zhuang)(zhuang)空氣過濾(lv)(lv)棉(mian)（主機(ji)(ji)進(jin)氣口(kou)處），每(mei)(mei)(mei)(mei)月(yue)更(geng)(geng)換(huan)或污(wu)染(ran)時(shi)及(ji)(ji)時(shi)更(geng)(geng)換(huan)三(san)、面(mian)(mian)(mian)(mian)罩(zhao)佩(pei)戴1.根據患(huan)者(zhe)臉(lian)型(xing)選擇合(he)適(shi)尺寸的鼻罩(zhao)/口(kou)鼻面(mian)(mian)(mian)(mian)罩(zhao)2.正確(que)安裝(zhuang)(zhuang)頭(tou)(tou)(tou)帶(dai)：-先固(gu)定上(shang)部頭(tou)(tou)(tou)帶(dai)，再調節下(xia)(xia)部-保(bao)持松(song)緊度適(shi)宜（可插入1-2指為佳）3.連(lian)(lian)接(jie)(jie)(jie)(jie)面(mian)(mian)(mian)(mian)罩(zhao)與(yu)管(guan)路，檢(jian)查(cha)硅膠墊(dian)是(shi)否(fou)(fou)完整(zheng)無破損四(si)、開(kai)(kai)(kai)機(ji)(ji)調試(shi)1.開(kai)(kai)(kai)啟電(dian)(dian)源(yuan)后(hou)觀察(cha)自檢(jian)程(cheng)序是(shi)否(fou)(fou)通(tong)過2.設(she)置參數（需人員操(cao)作）：-模式選擇（C/BI）-初始壓(ya)力建(jian)(jian)議從4-6cmH2O開(kai)(kai)(kai)始逐步(bu)上(shang)調3.測(ce)(ce)(ce)試(shi)漏(lou)氣量：開(kai)(kai)(kai)機(ji)(ji)后(hou)觀察(cha)面(mian)(mian)(mian)(mian)罩(zhao)周圍是(shi)否(fou)(fou)漏(lou)氣，調整(zheng)頭(tou)(tou)(tou)帶(dai)松(song)緊正常漏(lou)氣量應＜30L/min（視機(ji)(ji)型(xing)而定）注(zhu)意事項：1.使(shi)(shi)用(yong)建(jian)(jian)議在醫護人員指導下(xia)(xia)完成2.確(que)保(bao)管(guan)路無扭曲折疊，長(chang)汀(ting)呼(hu)(hu)吸檢(jian)測(ce)(ce)(ce)儀維(wei)修，建(jian)(jian)議使(shi)(shi)用(yong)管(guan)路支架3.每(mei)(mei)(mei)(mei)日消毒濕(shi)化罐(guan)和(he)面(mian)(mian)(mian)(mian)罩(zhao)，每(mei)(mei)(mei)(mei)周清潔過濾(lv)(lv)棉(mian)4.設(she)備(bei)(bei)應放(fang)置在穩(wen)固(gu)平面(mian)(mian)(mian)(mian)，與(yu)患(huan)者(zhe)保(bao)持0.5-1米安全(quan)(quan)距離(li)正確(que)安裝(zhuang)(zhuang)后(hou)需觀察(cha)患(huan)者(zhe)血氧飽和(he)度及(ji)(ji)舒(shu)適(shi)度，根據實(shi)際情況微調參數。建(jian)(jian)議每(mei)(mei)(mei)(mei)3個月(yue)進(jin)行(xing)設(she)備(bei)(bei)性能檢(jian)測(ce)(ce)(ce)，飛(fei)利(li)浦(pu)呼(hu)(hu)吸檢(jian)測(ce)(ce)(ce)儀維(wei)修，確(que)保(bao)壓(ya)力輸出精度誤差＜±2cmH2O。

無創(chuang)呼(hu)(hu)(hu)吸(xi)(xi)機（Non-InvasiveVentilation，NIV）通(tong)(tong)(tong)過鼻罩或面罩提(ti)供(gong)通(tong)(tong)(tong)氣(qi)(qi)(qi)支(zhi)(zhi)持，無需(xu)(xu)氣(qi)(qi)(qi)管插管，廣泛應用(yong)于(yu)(yu)急慢(man)性(xing)(xing)呼(hu)(hu)(hu)吸(xi)(xi)衰竭患(huan)(huan)(huan)(huan)者(zhe)(zhe)。其(qi)模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)包括以(yi)下(xia)幾種：###1.**C（持續(xu)氣(qi)(qi)(qi)道正(zheng)壓(ya)(ya)通(tong)(tong)(tong)氣(qi)(qi)(qi)）**-**原(yuan)(yuan)理(li)**：在整(zheng)個呼(hu)(hu)(hu)吸(xi)(xi)周期中提(ti)供(gong)恒定壓(ya)(ya)力(li)，維持氣(qi)(qi)(qi)道開(kai)放。-**適(shi)(shi)用(yong)場(chang)景**：阻(zu)塞(sai)性(xing)(xing)睡眠呼(hu)(hu)(hu)吸(xi)(xi)暫停（OSA）、急性(xing)(xing)心源性(xing)(xing)。可(ke)減少呼(hu)(hu)(hu)吸(xi)(xi)做功，改善氧合(he)(he)(he)。-**特點**：無主(zhu)動(dong)(dong)通(tong)(tong)(tong)氣(qi)(qi)(qi)支(zhi)(zhi)持，僅通(tong)(tong)(tong)過壓(ya)(ya)力(li)防止(zhi)肺泡(pao)塌陷。###2.**Bi（雙水平(ping)氣(qi)(qi)(qi)道正(zheng)壓(ya)(ya)通(tong)(tong)(tong)氣(qi)(qi)(qi)）**-**原(yuan)(yuan)理(li)**：設置吸(xi)(xi)氣(qi)(qi)(qi)相高壓(ya)(ya)（I）和(he)呼(hu)(hu)(hu)氣(qi)(qi)(qi)相低壓(ya)(ya)（E），通(tong)(tong)(tong)過壓(ya)(ya)差輔助患(huan)(huan)(huan)(huan)者(zhe)(zhe)呼(hu)(hu)(hu)吸(xi)(xi)。-**模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)細(xi)分(fen)**：-**S模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)（自(zi)(zi)主(zhu)觸(chu)發(fa)）**：患(huan)(huan)(huan)(huan)者(zhe)(zhe)自(zi)(zi)主(zhu)觸(chu)發(fa)呼(hu)(hu)(hu)吸(xi)(xi)，適(shi)(shi)用(yong)于(yu)(yu)意(yi)識清醒、呼(hu)(hu)(hu)吸(xi)(xi)驅動(dong)(dong)正(zheng)常(chang)的患(huan)(huan)(huan)(huan)者(zhe)(zhe)（如COPD穩定期）。-**T模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)（時(shi)間控制(zhi)）**：按預(yu)設頻率強制(zhi)送氣(qi)(qi)(qi)，用(yong)于(yu)(yu)呼(hu)(hu)(hu)吸(xi)(xi)微弱或性(xing)(xing)呼(hu)(hu)(hu)吸(xi)(xi)障礙患(huan)(huan)(huan)(huan)者(zhe)(zhe)。-**S/T模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)（自(zi)(zi)主(zhu)/時(shi)間結合(he)(he)(he)）**：優先患(huan)(huan)(huan)(huan)者(zhe)(zhe)觸(chu)發(fa)，若自(zi)(zi)主(zhu)呼(hu)(hu)(hu)吸(xi)(xi)不(bu)足則按后備(bei)頻率，兼(jian)顧靈活性(xing)(xing)與安全性(xing)(xing)。-**優勢**：降(jiang)低CO?潴(zhu)留(liu)，老(lao)人(ren)呼(hu)(hu)(hu)吸(xi)(xi)檢(jian)測儀維修，改善通(tong)(tong)(tong)氣(qi)(qi)(qi)效率，是COPD急性(xing)(xing)加重(zhong)、神經肌(ji)肉疾病(bing)的模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)。###3.**PCV（壓(ya)(ya)力(li)控制(zhi)通(tong)(tong)(tong)氣(qi)(qi)(qi)）**-**原(yuan)(yuan)理(li)**：預(yu)設目(mu)標壓(ya)(ya)力(li)，通(tong)(tong)(tong)過調(diao)整(zheng)吸(xi)(xi)氣(qi)(qi)(qi)時(shi)間及流(liu)速維持恒定壓(ya)(ya)力(li)，潮氣(qi)(qi)(qi)量(liang)(liang)隨肺順應性(xing)(xing)變化。-**適(shi)(shi)用(yong)場(chang)景**：肺順應性(xing)(xing)差或氣(qi)(qi)(qi)道阻(zu)力(li)高的患(huan)(huan)(huan)(huan)者(zhe)(zhe)（如ARDS、嚴重(zhong)），可(ke)減少氣(qi)(qi)(qi)壓(ya)(ya)險(xian)。###4.**AVAPS（平(ping)均容積(ji)保證壓(ya)(ya)力(li)支(zhi)(zhi)持）**-**原(yuan)(yuan)理(li)**：在Bi基礎上自(zi)(zi)動(dong)(dong)調(diao)整(zheng)I，確(que)保潮氣(qi)(qi)(qi)量(liang)(liang)達到預(yu)設目(mu)標。-**優勢**：兼(jian)顧壓(ya)(ya)力(li)支(zhi)(zhi)持與容積(ji)保障，適(shi)(shi)用(yong)于(yu)(yu)呼(hu)(hu)(hu)吸(xi)(xi)需(xu)(xu)求(qiu)波動(dong)(dong)大的患(huan)(huan)(huan)(huan)者(zhe)(zhe)（如肥胖低通(tong)(tong)(tong)氣(qi)(qi)(qi)綜合(he)(he)(he)征、漸(jian)凍癥(zheng)）。###5.**Auto-C/Auto-Bi（自(zi)(zi)動(dong)(dong)調(diao)壓(ya)(ya)模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)）**-**原(yuan)(yuan)理(li)**：通(tong)(tong)(tong)過算法實時(shi)監(jian)測氣(qi)(qi)(qi)道阻(zu)力(li)（如氣(qi)(qi)(qi)流(liu)、鼾聲），動(dong)(dong)態(tai)調(diao)整(zheng)壓(ya)(ya)力(li)水平(ping)。-**適(shi)(shi)用(yong)場(chang)景**：OSA患(huan)(huan)(huan)(huan)者(zhe)(zhe)的長(chang)期家庭治療，可(ke)減少壓(ya)(ya)力(li)過高引起的不(bu)適(shi)(shi)。###6.**PSV（壓(ya)(ya)力(li)支(zhi)(zhi)持通(tong)(tong)(tong)氣(qi)(qi)(qi)）**-**原(yuan)(yuan)理(li)**：患(huan)(huan)(huan)(huan)者(zhe)(zhe)觸(chu)發(fa)吸(xi)(xi)氣(qi)(qi)(qi)后，老(lao)人(ren)呼(hu)(hu)(hu)吸(xi)(xi)檢(jian)測儀維修，呼(hu)(hu)(hu)吸(xi)(xi)機提(ti)供(gong)預(yu)設壓(ya)(ya)力(li)輔助，呼(hu)(hu)(hu)氣(qi)(qi)(qi)切換由流(liu)量(liang)(liang)閾值決定。-**特點**：增強患(huan)(huan)(huan)(huan)者(zhe)(zhe)自(zi)(zi)主(zhu)呼(hu)(hu)(hu)吸(xi)(xi)能力(li)，常(chang)用(yong)于(yu)(yu)脫機訓練或輕(qing)度(du)呼(hu)(hu)(hu)吸(xi)(xi)肌(ji)疲勞。###**模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)選(xuan)擇原(yuan)(yuan)則**-**阻(zu)塞(sai)性(xing)(xing)疾病(bing)**（如COPD、OSA）：優先Bi（S/T模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)）或Auto-C。-**限制(zhi)性(xing)(xing)通(tong)(tong)(tong)氣(qi)(qi)(qi)障礙**（如肺纖維化）：適(shi)(shi)用(yong)PCV或AVAPS模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)。-**性(xing)(xing)呼(hu)(hu)(hu)吸(xi)(xi)抑制(zhi)**：需(xu)(xu)T模(mo)(mo)式(shi)(shi)(shi)(shi)(shi)提(ti)供(gong)后備(bei)通(tong)(tong)(tong)氣(qi)(qi)(qi)頻率。-**急性(xing)(xing)心源性(xing)(xing)**：C可(ke)快速改善氧合(he)(he)(he)。臨床(chuang)中需(xu)(xu)結合(he)(he)(he)血(xue)氣(qi)(qi)(qi)分(fen)析、患(huan)(huan)(huan)(huan)者(zhe)(zhe)舒適(shi)(shi)度(du)及病(bing)因綜合(he)(he)(he)選(xuan)擇，并動(dong)(dong)態(tai)調(diao)整(zheng)參數，以(yi)實現治果。