无创正压通气联合纳洛酮治疗肺性脑病疗效观察

Effect of noninvasive positive airway pressure ventilation combined with naloxone in the treatment of pulmonary encephalopathy

目的:探讨无创双水平正压通气(B iPAP)联合纳洛酮治疗慢性阻塞性肺疾病合并轻、中型肺性脑病的临床疗效。方法:选择慢性阻塞性肺疾病合并轻、中型肺性脑病患者60例,随机分为对照组和治疗组,对照组采用常规治疗,治疗组在常规治疗基础上加用无创B iPAP治疗联合静脉应用纳洛酮,观察两组患者治疗48 h后临床症状改善情况,记录两组治疗前后血气指标。结果:治疗48 h后,治疗组临床症状、血气指标改善情况均优于对照组(P<0.05),两组治疗后较治疗前血气指标均明显改善(P<0.01)。结论:在常规治疗基础上,采用无创B iPAP联合纳洛酮治疗慢性阻塞性肺疾病并轻、中型肺性脑病临床效果确切,值得临床推广应用,但要注意无创B iPAP的缺点。

Objective： To investigate clinical effect of noninvasive bi-level positive airway pressure ventilation combined with naloxone in the treatment of chronic obstructive pulmonary disease complicated with light,medium-scale pulmonary encephalopathy.Methods： The patients of chronic obstructive pulmonary disease complicated with light,medium-scale pulmonary encephalopathy were studied（n=60）.We random divided into control group and therapeutic group.The control group performed conventional therapy,and the therapeutic group were treated by conventional therapy combined with noninvasive bi-level positive airway pressure ventilation and naloxone,to observate the clinical symptoms changes after two groups patients were treated 48 hours,and blood gas index of pretherapy and post-treatment were recorded.Results： After therapy,the changes of the clinical symptoms and blood gas index significantly improvement in the therapeutic group compared with that of control group（P0.05）.The post-treatment blood gas index significantly improvement compared with that pretherapy in two groups（P0.01）.Conclusion： We used conventional therapy combined with noninvasive bi-level positive airway pressure ventilation and naloxone to treat chronic obstructive pulmonary disease complicated with light,medium-scale pulmonary encephalopathy,the clinical effect is definitive and extend-worthy in clinical,but attention adverse effect.