纳洛酮对慢性阻塞性肺病伴Ⅱ型呼吸衰竭并发肺性脑病28例疗效观察

Observation of naloxone in the treatment of 28 cases of COPD with pulmonary encephalopathy and type Ⅱ respiratory failure

目的观察纳洛酮治疗慢性阻塞性肺病(COPD)伴Ⅱ型呼吸衰竭并发肺性脑病的临床疗效。方法将56例COPD伴Ⅱ型呼吸衰竭并发肺性脑病患者随机分为纳洛酮治疗组及对照组,对照组给予常规综合治疗,治疗组在综合治疗基础上加用纳洛酮治疗。比较治疗前后组内和组间动脉血气及神志精神变化。结果纳洛酮治疗组和对照组总有效率分别为93.7%、64.3%(P<0.05)。治疗组治疗前后PaCO2分别为(70.5±9.9)mmHg和(36.8±12.4)mmHg,PaO2分别为(46.2±0.1)mmHg和(85.8±12.6)mmHg,差异均有统计学意义(P<0.01)。治疗组治疗后动脉PaCO2、PaO2改善均显著优于对照组,差异有统计学意义(P<0.01)。结论纳洛酮对COPDⅡ呼吸衰竭并发肺性脑病治疗安全有效,疗效显著。

Objective To observe the clinical effect of naloxone in treatment of chronic obstructive pulmonary disease （COPD） with pulmonary encephalopathy and type Ⅱrespiratory failure. Methods 56 patients of COPD with pulmonary encephalopathy and type Ⅱ respiratory failure were randomly divided into two groups, control group with basic therapy, treatment group with naloxone on the basic of basic therapy. The arterial blood gas and mind change before and after the therapy was compared. Results The overall effective rate of control group and treatment group were 93.7% and 64.3%, respectively （P〈0.05）. PaCO2. before and after treatment were （70.5±9.9） mmHgand （36.8±12.4） mmHg, respectively （ P 〈 0.01 ）, PaO2 before and after treatment were （ 85.8 ± 12.6 ） mmHg and （46.2 ± 0. 1 ） mmHg, respectively, （ P 〈 0.01 ）. After treatment the effective rate in the treatment group was significantly higher than in the control group （P 〈0.01 ）. Conclusion Naloxone is an effective medicine for treatment of COPD with pulmonary encephalopathy and type Ⅱ respiratory failure.