高频喷射通气加纳洛酮治疗肺性脑病15例疗效观察

HFJV with naloxone in treating 15 cases of pulmonary encephalopathy

为探讨高频喷射通气加纳洛酮抢救肺性脑病的临床疗效(肺性脑病,以下简称肺脑)。对30例肺脑昏迷患者随机分治疗与对照两组,对照组予以常规治疗,治疗组除常规治疗外,使用高频喷射通气加纳洛酮静注。结果:治疗组在解除呼吸抑制,快速催醒,改善紫绀方面有效率分别为80％、86％、96％,优于对照组53％、60％、66％;病死率:对照组26％,治疗组6％,下降20％;血气分析显示:对照组PaO_2由治疗前6.78±2.02kPa,治疗后提高到8.90±1.86kPa,SaO_2则由治疗前79.5±9.65％治疗后提高到82.25±9.52％。治疗组PaO_2由治疗前6.85±1.08kPa治疗后提高到11.33±1.65,SaO_2由治疗前76.2±11.26％治疗后提高到96.2±2.89％,两组治疗前后比较有显著差异,P<0.01,而PaCO_2、pH两组治疗前后相比无显著差异,P>0.05。结论:高频喷射通气加纳洛酮抢救肺脑,对提高PaO_2、SaO_2疗效显著,对解除呼吸抑制,快速催醒,改善紫绀效果确切,此方法简便,副作用小,值得临床推广。

Discussion on the clinical effect of HFJV with naloxone in saving pulmonary encephalopathy cases.The 30 comatose cases with the disease were divided into random groups of therapeutic one and control one.Control group with routine treament,therapeutic group with extra treatment of HFJV and naloxone(IV).Results:In therapeutic group,the effective rate of releasing respiratory inhibition,quickly awakening and improving cyanosis are 80%,86%,96%,better than 53%,60%,66% in control group.Death rate:26% in control group,6% in therapeutic group.Blood gas analysis:in control group,PaO 2 from 6.78±2.02kPa to 8.90±1.86kPa after treatment.SaO 2 from 79.5±9.65% to 82.25±9.52%.In therapeutic group,PaO 2 from 6.85±1.08kPa to 11.33 ±1.65,SaO 2 from 76.2±11.26% to 96.2±2.89%.The two groups had marked difference, P <0.01,but no clear difference in PaCO 2,pH, P >0.05.Conclusion:HFJV with naloxone is very effective in treating the disease.It is easily applied and with fewer side effects.