纳洛酮与尼可刹米治疗慢性阻塞性肺疾病急性加重期并发肺性脑病的效果比较

Analysis of the rapeutic effect of Naloxone and Nikethamide on AECOPD with pulmonary encephalopathy

目的比较纳洛酮与尼可刹米治疗慢性阻塞性肺疾病急性加重期(AECOPD)并发肺性脑病的临床疗效。方法符合诊断标准的76例AECOPD并发肺性脑病患者,在予吸氧、抗感染、解痉平喘以及对症支持等治疗基础上,采用抓阄法随机分为两组,治疗组给予纳洛酮,对照组给予尼可刹米治疗,对比观察两组治疗前后神志、呼吸、心率、血气情况的变化。结果与对照组比较,治疗组患者的临床症状心累气紧及神志异常明显改善,血气分析好转,两者相比差异有统计学意义(P<0.05)。结论纳洛酮作为中枢神经兴奋剂,对AECOPD并发肺性脑病患者的大脑皮层供氧,兴奋呼吸中枢有明显改善,且不良反应少,安全有效。

Objective To evaluate the clinical therapeutic effect of naloxone and nikethamide on AECOPD with pulmonary encephalopathy and analysis its mechanism.Methods 76 patients with AECOPD with pulmonary encephalopathy were randomized into two groups: the therapeutic group(n = 38) were given the treatment of naloxone and the control group(n = 38) treated with nikethamide separately.The change of R,HR,pH,PaO2 and PaCO2 was recorded,meanwhile observed the side effect as well as effect analysis.Results Compare to control group,the clinical symptoms and pH,PaO2,PaCO2 of the therapeutic group were ameliorated significantly,and there was significant difference between 2 groups(P < 0.05).Conclusion The treatment of naloxone can improve the lung function and the clinical symptom of patients of AECOPD with pulmonary encephalopathy,which has less adverse effect.