中西醫照護幫助患者脫離呼吸器－病例報告

Successfully Weaning in Respiratory Failure Patient by Integration of Traditional and Western Medicine: A Case Report

陳稼洺(Jia-Ming Chen) ； 李佳穎(Chia-Ying Lee) ； 許博期(Po-Chi Hsu) ； 羅綸謙(Lun-Chien Lo)

《中醫藥雜誌》 25卷1期 (2014/06) Pp. 113-124

https://doi.org/10.3966/101764462014062501008

摘要

這位58歲的男性患者，於2012-02-07因呼吸喘促，全身無力及發燒至40℃度等症狀，入院診斷為急性呼吸衰竭、吸入性肺炎，經插管住進內科加護病房接受治療。住院一星期後，因腹脹、消化差及血紅素持續降低，懷疑上消化道出血，經進一步檢查後，診斷為胃腺癌，於2012-02-20進行胃及空腸切除，並開始使用Gastrostomy-Jejunostomy feeding tube（G-J feeding tube）。入院一個月後，患者因生命徵象逐漸穩定，轉入呼吸照護中心持續治療，於2012-03-12會診中醫，盼協助脫離呼吸器。經中醫會診後，證型診斷為脾肺氣虛，治則以補脾益肺、補土生金益氣為主，方藥則以補中益氣湯加減，經2個多星期的中藥治療後，患者症狀獲得明顯改善且脫離呼吸器並順利出院。

關鍵字

急性呼吸衰竭 ； 呼吸器 ； 脾肺氣虛 ； 補中益氣湯 ； 中醫

並列摘要

This 58-year-old male patient presented with shortness of breath, general weakness and fever up to 40˚C before admission. Respiratory failure and aspiration pneumonia was diagnosed. Then, intubation was performed with endotracheal tube and the patient was transferred to MICU. A week later, upper gastrointestinal bleeding was suspected with the clinical symptoms of abdominal distention, poor digestion and reduced hemoglobin. Gastric adenocarcinoma was diagnosed after further examination. After one month of hospitalization, his vital sign was stable and was transferred to respiratory care center. Traditional Chinese medicine (TCM) was consulted on 2012-03-12. The diagnosis was Lung and Spleen Qi deficiency and herbal remedies such as Bu Zhong Yi Qi Tang was prescribed throughout the whole treatment period. After TCM treatment for two weeks, the clinical symptoms of patient were much relieved during respiratory training course and had more opportunity for weaning. Finally, he was weaned from successfully and recovered very well. Therefore, we would like to share this experience with the Chinese Medicine practitioners who are interested in this specific condition.

並列關鍵字

Acute respiratory failure ； aspiration pneumonia ； traditional Chinese medicine ； Lung and Spleen Qi deficient ； Bu Zhong Yi Qi Tang

參考文獻

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