纳络酮治疗慢性阻塞性肺疾病所致肺性脑病38例临床观察

The therapeutical effects of naloxone on chronic obstractive pulmonary disease induced pulmonary encephalopathy 38 cases report

目的探讨纳络酮对慢性阻塞性肺疾病（COPD）急性发作期合作并肺性脑病（PEP）的临床疗效。方法选择我院自2001年1月-2004年12月76例COPD急性发作期合并肺性脑病患者，分成两组：应用纳络酮组为试验组（A组），未用纳络酮组为对照组（B组），每组各38例。观察用药前后的意识状态，呼吸、血压、心率、动脉血气分析的变化。结果A组用药后24小时内意识障碍消失30例（78．9％）、48小时内36例（89．5％）；而B组24小时内有13例意识障碍消失（34．2％）、48小时内22例（50．0％）。二者相比有显著性差异。血压无显著意义变化。A组用药后呼吸、心率有显著意义的下降（P〈0．05），呼吸频率下降8—150次／分，心率下降20—400次／分。PaCO2与用药前相比，有显著意义的下降（P〈0．05），下降2．8—5．6kPa。PaO2与用药前相比均有显著意义的升高（P〈0．05），升高2．1～3．6kPa。A组RR、HR、PaCO2明显低于B组（P〈0．05），PaO2明显高于B组（P〈0．05）。结论纳络酮对COPD急性发作期合并的肺性脑病，具有一定的治疗作用。

Objective To study the therapeutical effects o＇f Naloxone on Chronic obstructive pulmonary disease induced Pulmonary encephalopathy. Methods The 76 patients with Chronic obstructive pulmonary disease induced Pulmonary encephalopathy from Janary 2001 to december 2004 were chosen to bedivided into two groups. First is 38cases （named group -A） to be iv Naloxone till the patients recover from the conscious disturbance. The consciousnesswere observed, respiratory rate,blood pressure,heart rate and arterial gasanalysis of the patients were measured before and after the drug administration. Results 30 cases in group - A recover from the conscious disturbance in 24 hours（78.9% ） ,36 cases in group - A recover from the conscious disturbance in 48 hours（89.5% ）, 13 cases in group - B recover from the conscious disturbance in 24 hours（34.2% ） ,22 cases in group - B recover from the consious disturbance in 48 hours（50.0% ）. There is significantly difference in two groups, In group -A. There is no significant changes in blood pressure, Respiratory rate and heart rate significantly decrease after the drug administration （P 〈 0.05 ）. PaO2 significantly increased after the drug administration . The extent increased were from 2.1 kPa to 3.6 kPa, respectively （P 〈 0.05 ） . PaCO2 significantly decreasedl the degrees of drops were from 2.8 kPa to 5.6 kPa （ P 〈 0. 05 ） . Respiratory rate, Heart rate and PaCO2 in group - A significantly decrease （P 〈 0.05 ）. PaO2 in group - A Signficantly increase respectively （P 〈 0.05 ） . Conclusion Our study shows that Naloxone has definitively therapeutical effects on the Patients with Chronic obstructive pulmonary disease induced Pulmonary encephalopathy.