纳洛酮联合无创呼吸机治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭的临床效果观察
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摘要
目的观察纳洛酮联合无创呼吸机治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭的临床效果。方法将2016年3月‐2017年2月治疗的82例AECOPD合并Ⅱ型呼吸衰竭患者作为研究对象,将其依照随机数表法分为两组,各41例。对照组实施常规治疗,观察组则加以纳洛酮、无创呼吸机治疗。观察两组临床疗效、不良反应、治疗前后血气指标变化情况。结果两组治疗总有效率、急性加重发生率相比,观察组均优于对照组,差异有统计学意义(P <0.05);两组不良反应发生率对比,差异无统计学意义(P>0.05);治疗前两组二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、酸碱度(PH)、心率、呼吸频率对比,差异无统计学意义(P>0.05);治疗后观察组PaO2、PH高于对照组,PaCO2低于对照组,差异有统计学意义(P <0.05)。结论将纳洛酮与无创呼吸机联合治疗AECOPD合并Ⅱ型呼吸衰竭效果确切,利于改善患者血气指标与不良症状,降低急性加重发作风险,安全性良好。
【Objective】To observe the clinical effects of naloxone and noninvasive ventilator in treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) combined with type Ⅱ respiratory failure.【Methods】Eightytwo patients with AECOPD combined with type Ⅱ respiratory failure treated from March 2016 to February 2017 were selected, and they were divided into two groups by random number table, 41 cases in each group. Control group was given routine treatment, while observation group was treated with naloxone and noninvasive ventilator. The clinical efficacy, adverse reactions, changes of blood gas indexes in the two groups were observed.【Results】The total effective rate and the incidence of acute exacerbation in observation group were better than those in control group(P <0.05); there was no statistical difference in the incidence of adverse reactions between the two groups(P >0.05); before treatment, there was no statistical difference in the partial pressure of carbon dioxide(PaCO2), arterial oxygen pressure(PaO2), power of hydrogen(PH), heart rate, and respiratory rate between the two groups(P >0.05); after treatment, the PaO2 and PH in observation group were higher than those in control group, while PaCO2 was lower in observation group than in control group(P <0.05).【Conclusion】Naloxone and noninvasive ventilator in treatment of AECOPD combined with type Ⅱ respiratory failure is effective, and it can improve blood gas indexes and adverse symptoms, decrease the incidence of acute exacerbation and have good safety.
【Objective】To observe the clinical effects of naloxone and noninvasive ventilator in treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) combined with type Ⅱ respiratory failure.【Methods】Eightytwo patients with AECOPD combined with type Ⅱ respiratory failure treated from March 2016 to February 2017 were selected, and they were divided into two groups by random number table, 41 cases in each group. Control group was given routine treatment, while observation group was treated with naloxone and noninvasive ventilator. The clinical efficacy, adverse reactions, changes of blood gas indexes in the two groups were observed.【Results】The total effective rate and the incidence of acute exacerbation in observation group were better than those in control group(P <0.05); there was no statistical difference in the incidence of adverse reactions between the two groups(P >0.05); before treatment, there was no statistical difference in the partial pressure of carbon dioxide(PaCO2), arterial oxygen pressure(PaO2), power of hydrogen(PH), heart rate, and respiratory rate between the two groups(P >0.05); after treatment, the PaO2 and PH in observation group were higher than those in control group, while PaCO2 was lower in observation group than in control group(P <0.05).【Conclusion】Naloxone and noninvasive ventilator in treatment of AECOPD combined with type Ⅱ respiratory failure is effective, and it can improve blood gas indexes and adverse symptoms, decrease the incidence of acute exacerbation and have good safety.
引文
[1]张遂甫,陈晓平,陈永生,等.无创正压通气联合纳洛酮治疗慢性阻塞性肺疾病急性加重期并发呼吸衰竭的耐受性及安全性分析[J].医学研究杂志, 2015, 44(6):151-154.
[2]刘莉丽,孟建斌,王文欣,等.纳洛酮联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床研究[J].中国临床药理学杂志, 2016, 32(16):1443-1445.
[3]张治.无创正压通气联合盐酸纳洛酮注射液治疗慢性阻塞性肺疾病急性加重期并呼吸衰竭的临床疗效及其对患者肺功能和生活质量的影响[J].实用心脑肺血管病杂志, 2016, 24(7):47-50.
[4]李晓娅.有创机械通气联合纳洛酮治疗慢性阻塞性肺疾病急性加重期的疗效观察[J].实用临床医药杂志, 2016, 20(15):85-87.
[5]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013, 36(4):255-264.
[6]袁章安,熊忠林. AECOPD伴呼吸衰竭患者应用纳洛酮治疗临床疗效[J].临床肺科杂志, 2017, 22(3):486-488.
[7]姜俊广,王海波,陈树伟.无创正压通气联合纤维支气管镜肺灌洗治疗老年慢性阻塞性肺疾病急性加重期合并II型呼吸衰竭患者临床观察[J].医学综述, 2016, 22(1):167-170.
[8]文申英,王小军,廖涛,等.尼可刹米与纳洛酮联合无创正压通气治疗AECOPD并发呼吸衰竭[J].现代生物医学进展,2016, 16(31):6110-6113.
[9]曹秀丽,罗勇.无创正压通气治疗慢性阻塞性肺疾病急性加重并II型呼吸衰竭的疗效分析[J].中国煤炭工业医学杂志,2015, 18(6):892-894.
[10]刘印红,张勇,张扬,等.纳洛酮联合无创呼吸机对老年慢性阻塞性肺疾病合并呼吸衰竭患者血气指标、肺功能的影响[J].贵州医药, 2016, 40(5):486-488.
[11]张月秋,陈敢峰.纳洛酮联合NIPPV治疗COPD合并II型呼吸衰竭的效果观察[J].山东医药, 2015(13):77-78.
[12]熊汉忠,胡克,翁光明,等.纳洛酮治疗慢性阻塞性肺病合并II型呼吸衰竭患者临床疗效研究[J].现代生物医学进展,2015, 15(27):5263-5267.
[2]刘莉丽,孟建斌,王文欣,等.纳洛酮联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床研究[J].中国临床药理学杂志, 2016, 32(16):1443-1445.
[3]张治.无创正压通气联合盐酸纳洛酮注射液治疗慢性阻塞性肺疾病急性加重期并呼吸衰竭的临床疗效及其对患者肺功能和生活质量的影响[J].实用心脑肺血管病杂志, 2016, 24(7):47-50.
[4]李晓娅.有创机械通气联合纳洛酮治疗慢性阻塞性肺疾病急性加重期的疗效观察[J].实用临床医药杂志, 2016, 20(15):85-87.
[5]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013, 36(4):255-264.
[6]袁章安,熊忠林. AECOPD伴呼吸衰竭患者应用纳洛酮治疗临床疗效[J].临床肺科杂志, 2017, 22(3):486-488.
[7]姜俊广,王海波,陈树伟.无创正压通气联合纤维支气管镜肺灌洗治疗老年慢性阻塞性肺疾病急性加重期合并II型呼吸衰竭患者临床观察[J].医学综述, 2016, 22(1):167-170.
[8]文申英,王小军,廖涛,等.尼可刹米与纳洛酮联合无创正压通气治疗AECOPD并发呼吸衰竭[J].现代生物医学进展,2016, 16(31):6110-6113.
[9]曹秀丽,罗勇.无创正压通气治疗慢性阻塞性肺疾病急性加重并II型呼吸衰竭的疗效分析[J].中国煤炭工业医学杂志,2015, 18(6):892-894.
[10]刘印红,张勇,张扬,等.纳洛酮联合无创呼吸机对老年慢性阻塞性肺疾病合并呼吸衰竭患者血气指标、肺功能的影响[J].贵州医药, 2016, 40(5):486-488.
[11]张月秋,陈敢峰.纳洛酮联合NIPPV治疗COPD合并II型呼吸衰竭的效果观察[J].山东医药, 2015(13):77-78.
[12]熊汉忠,胡克,翁光明,等.纳洛酮治疗慢性阻塞性肺病合并II型呼吸衰竭患者临床疗效研究[J].现代生物医学进展,2015, 15(27):5263-5267.