BiPAP联合纳络酮在COPD合并肺性脑病治疗中的应用研究

Clinical study of BiPAP combined naloxone in the treatment of patients with COPD combined pulmonary encephalopathy

目的研究双水平无创正压通气联合纳络酮对慢性阻塞性肺疾病合并肺性脑病的临床疗效。方法将2007年6月～2009年1月我院收治的43例慢阻肺呼吸衰竭合并肺性脑病患者随机分为治疗组和对照组,对照组采用双水平无创正压通气和常规治疗,治疗组采用双水平无创正压通气联合纳络酮及常规治疗。结果两组患者治疗结果存在显著差异,与对照组比较,治疗组患者意识障碍恢复快,血气分析改善明显,气管插管率明显降低,治疗有效率高。结论无创双水平气道正压通气联合纳络酮治疗慢性阻塞性肺疾病合并肺性脑病可以提高增加人机协调率,提高无创正压通气的疗效,降低患者的气管插管率。

Objective To investigate the clinical efficacy of non-invasive bi-level positive pressure ventilation （BiPAP）combined with naloxone in chronic obstructive pulmonary disease patients with pulmonary encephalopathy. Methods The 43 patients with COPD combined with pulmonary encephalopathy in our hospital from June 2007 to January 2009 were randomly divided into treatment group and control group. The treatment group was treated with BiPAP, as well as conventional therapeutic managements and naloxone administration, whereas,21 controls only received BiPAP and conventional intervention. Results There was significant difference between the 2 groups. There was faster recovery of consciousness and significant improvement in blood gas analysis in the treatment group. The tracheal intubation rate of the treatment group was lower than that of the control group. The efficiency of the treatment group was higher compared with the control group. Condusion Non-invasive bi-level positive pressure ventilation combined with naloxone treatment of chronic obstructive pulmo- nary diseases with pulmonary encephalopathy may increase the curative effects of non-invasive BiPAP ventilation and decrease the tracheal intubation rate.