慢性阻塞性肺疾病并肺性脑病的患者早期应用无创呼吸机联合尼可刹米治疗的疗效分析
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摘要
目的分析慢性阻塞性肺疾病并肺性脑病的患者早期应用无创呼吸机联合尼可刹米治疗的疗效。方法选取该院于2016年1月—2018年8月诊治的100例慢性阻塞性肺疾病合并肺性脑病患者,随机纳入治疗组和对照组,对照组实施无创呼吸机治疗,治疗组应用无创呼吸机联合尼可刹米治疗,对比临床疗效。结果在接受治疗后24 h,48 h两组患者PaO_2、PaCO_2水平有所改善,治疗组患者接受治疗后PaCO_2 24 h治疗指标(50.6±3.2)mmHg,48 h指标(43.2±2.5)mmHg;与对照组PaO_2 24 h治疗指标(69.9±3.7)mmHg,48 h指标(54.9±3.7)比较(t=12.283、11.093,P<0.05)。治疗组患者接受治疗后PaO_224 h治疗指标(83.9±2.8)mmHg,48 h指标(93.4±3.6)mmHg;与对照组PaO_224 h治疗指标(70.6±3.2)mmHg,48 h指标(74.1±2.1)mmHg比较(t=11.893,10.156,P<0.05)。治疗组患者的气管插管率、并发症发生率均低于对照组,且获得了更高的治疗有效率,组间数据互比可见差异有统计学意义(χ~2=11.293、10.972、8.926,P<0.05)。结论慢性阻塞性肺疾病合并肺性脑病应用无创呼吸机联合尼可刹米治疗,能够增强患者的治疗效果,促进症状、体征改善,及早减轻痛苦。
Objective To analyze the efficacy of early noninvasive ventilator combined with nikethamide in patients with chronic obstructive pulmonary disease and pulmonary encephalopathy. Methods 100 patients with chronic obstructive pulmonary disease complicated with pulmonary encephalopathy who were treated in our hospital from January2016 to August 2018 were randomly selected into the treatment group and the control group. The control group was treated with non-invasive ventilator, and the treatment group with non-invasive ventilator combined with nikethamide treatment, comparing clinical efficacy. Results The levels of PaO_2 and PaCO_2 were improved in the two groups at 24 hours and 48 hours after treatment. The treatment group received PaCO_224 hours of treatment(50.6±3.2)mmHg and 48 hours(43.2 ±2.5)mmHg, PaO_224 hours treatment index(69.9 ±3.7)mmHg, 48 hours index(54.9 ±3.7)mmHg(t =12.283,11.093, P <0.05). The treatment group received PaO_224 hours treatment index(83.9 ±2.8)mmHg and 48 hours index(93.4±3.6)mmHg after treatment. Compared with the control group PaO_224 hours treatment index(70.6±3.2)mmHg, 48 hours index(74.1±2.1)mmHg(t=11.893,10.156, P<0.05). The tracheal intubation rate and complication rate of the treatment group were lower than those of the control group, and higher treatment efficiency was obtained. The statistical difference between the data of the groups was observed(χ~2=11.293, 10.972, 8.926, P<0.05). Conclusion The treatment of chronic obstructive pulmonary disease with pulmonary encephalopathy using non-invasive ventilator combined with nikethamide can enhance the patient's therapeutic effect, promote the improvement of symptoms and signs, and relieve pain early.
Objective To analyze the efficacy of early noninvasive ventilator combined with nikethamide in patients with chronic obstructive pulmonary disease and pulmonary encephalopathy. Methods 100 patients with chronic obstructive pulmonary disease complicated with pulmonary encephalopathy who were treated in our hospital from January2016 to August 2018 were randomly selected into the treatment group and the control group. The control group was treated with non-invasive ventilator, and the treatment group with non-invasive ventilator combined with nikethamide treatment, comparing clinical efficacy. Results The levels of PaO_2 and PaCO_2 were improved in the two groups at 24 hours and 48 hours after treatment. The treatment group received PaCO_224 hours of treatment(50.6±3.2)mmHg and 48 hours(43.2 ±2.5)mmHg, PaO_224 hours treatment index(69.9 ±3.7)mmHg, 48 hours index(54.9 ±3.7)mmHg(t =12.283,11.093, P <0.05). The treatment group received PaO_224 hours treatment index(83.9 ±2.8)mmHg and 48 hours index(93.4±3.6)mmHg after treatment. Compared with the control group PaO_224 hours treatment index(70.6±3.2)mmHg, 48 hours index(74.1±2.1)mmHg(t=11.893,10.156, P<0.05). The tracheal intubation rate and complication rate of the treatment group were lower than those of the control group, and higher treatment efficiency was obtained. The statistical difference between the data of the groups was observed(χ~2=11.293, 10.972, 8.926, P<0.05). Conclusion The treatment of chronic obstructive pulmonary disease with pulmonary encephalopathy using non-invasive ventilator combined with nikethamide can enhance the patient's therapeutic effect, promote the improvement of symptoms and signs, and relieve pain early.
引文
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[14]谢柏梅,敬梅,路晓艳.CPIS评分及血清PCT在慢性阻塞性肺疾病呼吸机相关性肺炎诊断和预后判断中的应用价值[J].临床和实验医学杂志,2018,17(15):1617-1620.
[15]董芳,郝雅芳,白相斌.慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者使用BiPAP呼吸机通气的疗效及安全性分析[J].国际呼吸杂志,2015,35(1):22-24.
[16]林大勇.慢性阻塞性肺疾病合并呼吸衰竭患者经无创呼吸机治疗的临床效果观察[J].中国当代医药,2016,23(5):41-43.
[2]吴亚男.早期药物治疗慢性呼吸衰竭并肺性脑病临床观察[J].中国实用神经疾病杂志,2012,15(6):60-61.
[3]卓安山,李奕,官振标.无创正压通气联合纳洛酮治疗慢性阻塞性肺疾病急性发作合并肺性脑病的临床研究[J]疑难病杂志,2014,13(8):800-803.
[4]徐媛.双水平无创正压通气联合呼吸兴奋剂在COPD合并肺性脑病治疗中的应用[J].山东医药,2015,55(26):77-79.
[5]代春伟.早期应用药物治疗慢性呼吸衰竭并发肺性脑病疗效观察[J].临床医学,2014(3):47-48.
[6]杜章辉.慢性阻塞性肺疾病合并呼吸衰竭无创呼吸机治疗临床分析[J].中国社区医师,2018,34(5):31.
[7]叶锋.慢性阻塞性肺疾病急性发作合并Ⅱ型呼衰经无创呼吸机治疗的临床效果研究[J].中国初级卫生保健2018,32(4):52-53.
[8]曹先华,吴秀娟,蔡香香.慢性阻塞性肺疾病合并呼吸衰竭患者应用无创呼吸机治疗的效果分析[J].智慧健康2018,4(2):158-159.
[9]张家玲.慢性阻塞性肺疾病合并重症呼吸衰竭患者采用无创呼吸机的应用效果[J].医疗装备,2018,31(2):168-169.
[10]王林梅.适应性支持通气在慢性阻塞性肺疾病并发呼吸衰竭老年患者撤除呼吸机过程中的应用价值[J].新乡医学院学报,2018,35(9):810-812.
[11]安亚东.呼吸衰竭合并慢性阻塞性肺疾病的有创与无创呼吸机序贯治疗[J].中国实用医药,2014(17):171-172.
[12]袁魁远,杨莉红,田丽丽.老年慢性阻塞性肺疾病合并呼吸衰竭患者应用BiPAP无创呼吸机的护理[J].医疗装备,2017,30(11):147-148.
[13]吴琼华.极重度慢性阻塞性肺疾病急性发作期使用有创呼吸机的安全护理管理[J].医疗装备,2017,30(16)173-174.
[14]谢柏梅,敬梅,路晓艳.CPIS评分及血清PCT在慢性阻塞性肺疾病呼吸机相关性肺炎诊断和预后判断中的应用价值[J].临床和实验医学杂志,2018,17(15):1617-1620.
[15]董芳,郝雅芳,白相斌.慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者使用BiPAP呼吸机通气的疗效及安全性分析[J].国际呼吸杂志,2015,35(1):22-24.
[16]林大勇.慢性阻塞性肺疾病合并呼吸衰竭患者经无创呼吸机治疗的临床效果观察[J].中国当代医药,2016,23(5):41-43.