纳洛酮联合无创机械通气治疗AECOPD并发轻中度肺性脑病疗效观察

Observation on the effect of naloxone and noninvasive bi-level positive airway pressure ventilation in the treatment of patients with chronic obstructive pulmonary disease

目的观察纳洛酮联合BIPAP无创机械通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)并发轻中度肺性脑病的临床疗效。方法选择AECOPD并发呼吸衰竭轻中度肺性脑病患者43例,均在有效抗感染、解痉平喘等常规治疗的基础上予以纳洛酮及BIPAP无创呼吸机辅助通气。分别在通气前、后3h、24h及72h后评价患者症状、意识状况、动脉血气分析。结果 43例中好转40例,失败3例,有效率93.02%,治疗3h后呼吸困难程度、血气指标有所改善,72h后明显好转,差异有统计学意义(P<0.05)。结论纳洛酮联合BIPAP无创正压机械通气可迅速缓解患者呼吸困难、改善患者意识状态及呼吸肌疲劳情况,是治疗AECOPD并发轻中度肺性脑病的一种有效治疗措施。

Objective To study the effect of naloxone and noninvasive bi-level positive airway pressure（BiPAP） ventilation in the treatment of patients with chronic obstructive pulmonary disease（COPD） with mild to moderate pulmonary encephalopathy.Methods AECOPD with mild to moderate pulmonary encephalopathy in 43 patients were given naloxone and BIPAP non-invasive mechanical on the basis of effective against infection,spasm,asthma and other conventional treatment ventilation.The breathing and arterial blood gas analysis of the patient were analyzed before ventilation and ventilation after 3 hours,24 hours and 72 hours.Results Forty patients improved,3 cases failure,effective rate was 93.02%.Dyspnea and blood indicators were improved after 3 hours,and significantly improved after 72 hours,the difference was statistically significant（P0.05）.Conclusion Naloxone joint BiPAP noninvasive positive pressure ventilation can quickly relieve breathing difficulties,and improve the state of consciousness and respiratory muscle fatigue situation.The treatment of AECOPD complicated by mild to moderate pulmonary encephalopathy is an effective alternative treatment measures.