“밤이 제일 무섭습니다”… 루게릭병 환자의 호흡 관리

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NIV �� ð� ȣ��Ȱ, �׸�� ùٸ� �� ü�� ߿伺

�� ۿ�� Ը�� ġ�ῡ�� ȣ�� ĸ� �¿��ϴ� �ٽ� �� ߴ�. �̹�� ȣ�ڵ�� η��ϴ� �ð�, ��㡯�� ¤��� Ѵ�.

��Ը��(ALS) ȯ�ڿ� ��ȣ�ڿ�� ޽�� ð�� ƴϴ�. ��ǿ�� ϳ�� ϴ١�� ̴�. �� Ƿ�� ְ�, �� ְ� ��ϰ� �ִٴ� ��̶� �ִ�. �׷�� Ǹ� Ȥ�� , �� ڱ� �� ϰ� �ȴ�. �� Ҹ�� ߸� �� ɴ´ٰ� ��ϴ� ȯ�ڵ� �ִ�.

�� ð��̴�. �� ȿ�� Ⱦ�ݸ�� ȣ�� κ� ��, ��鿡 ���� ̷�� Ѵ�. Ư�� (REM) �� ܰ迡�� ȣ�� 鼭 ��ȯ�Ⱑ �� ߻��Ѵ�. �̶� �߿�� ȭ�� ̻�ȭź�� ̴�. ��ħ ��, �� , ��߷� ��, ��ϱ� �� ҾȰ�� ȯ�Ⱑ �� ʾҴٴ� ��ȣ�� ִ�.

�� ̸� ��Ȯ�� Ȯ��ϴ� �� ʴٴ� ��̴�. ��ȭ�� , �̻�ȭź�� ľ��ϱ� ��ƴ�. ��ȣ�ڴ� ��ġ�� ٴµ� �� ̷�� ϱ�� ȥ�� ޴´�. �ᱹ �� ѷ�� ڿ�� ΰ�ȣ��⸦ ��ϰ� �Ǵ� ��찡 �� ʴ�.

��ħ�� ΰ�ȣ��(NIV)�� Ը�� ȯ�� Ⱓ�� ϰ� �� ϴ� ġ�� ˷�� ִ�. �׷�� ӻ󿡼�� . �Ϻ� �� Ǵ� �� 40% ��ؿ� ��ģ�ٴ� �� ִ�. ��ũ �йڰ�, �� , �� , �Ǻ� �ڱ�, �� ȯ�ڿ�� Ʈ��. Ư�� ϴ� �� Ư�� ϸ�, ��ũ�� ä �� ϴ� �� ʴ�. ��ȣ�� ۵� ��θ� Ȯ��ϴ�� Ѵ�.

�׷�� ߿�� ̴�. ȣ�� ް�� ȭ�� Ȳ�� ۽�� ϸ� �� źΰ�� Ŀ��. �ݴ�� ª�� ϰ�, �� ´� ��ũ�� ϸ�, ��⸦ �� ̸� �� ִ�. �ΰ�ȣ�� ܰ�� ƴ϶�, �� Ű�� غ� ��̾�� Ѵ�.

ü�� ؼ�� ȴ�. �� ȣ�ڰ� �� ü�� ٲٸ� ��, ��ġ�� ٷ� �� supine ü�� Ⱦ�ݸ�� о� �÷� �� Ȯ�� ϰ� �к� ��ü �� ִ�. �ݴ�� lateral ü�� з�� ߽�� ȯ�� ұ�� ʷ�� ִ�. �ӻ��δ� �� 30�� semi-lateral �ڼ�, �� ʰ� �� ٷ� �� ʴ� �߰� �ڼ�� 찡 ��. �� ణ �� л��Ű��, ��ݰ� �� ִ� �� ϴ� �͵� �� ȴ�. ü�� ܼ�� ƴ϶� ȯ�� ȿ�� ȴ�.

�� ȣ�� Ȱ�� ݵ�� Ǿ�� Ѵ�. ��ħ��߱�(�� ġ)�� Ȱ�� Ϸ� �� ̻� �к� �� , ��Ģ�� ȣ�� Ʒ�� ϴ� �� Ű� �޼� ��ȭ�� ϴ� �� ġ�� ̴�. �� Ǳ� ��ؼ�� غ� �ʿ��ϴ�.

��õ� �㿡 NIV ��ũ�� Ʋ�� , T-tube�� , ��Ⱑ �� ῡ�� ȯ�ڿ� ��ȣ�ڵ�� ִ�. �� η�� ̶� �پ�� ֵ��, �� ġ�� ü�谡 ��õǱ⸦ �ٶ�� ģ��. �� , ġ�� ư��.

* �� Į�� ｺ�� ġ�� ֽ��ϴ�.

�� ġ��ް� �� 300�� Ѵ� ��Ը��(��ȭ��)ȯ�ڵ�� ټ�� Ű��ͳ�ġ�� ȯ ȯ�ڵ�, �׸�� Ÿ �� ȯ, ��ȯ�� ġ�� ȯ�ڵ�� Ͽ� ��Ը�� ȯ ġ�� ⿡ �� ǰ�� մϴ�.

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