纳洛酮治疗慢阻肺并Ⅱ型呼吸衰竭的疗效及安全性评价

Observation of the clinical effect and safety of naloxone in the treatment of chronic respiratory failure with Ⅱ type of respiratory failure

目的探讨纳洛酮治疗慢阻肺并Ⅱ型呼吸衰竭的疗效及安全性。方法将2007年7月～2012年7月入住我院的100例经临床病理学诊断为慢阻肺并Ⅱ型呼吸衰竭患者随机分为对照组与观察组，各为50例。对照组给予抗感染、平喘、祛痰以及纠正水电之平衡等对症治疗，观察组在此基础上给予纳洛酮0．18mg＋0．9％生理盐水10mL静脉注射，2次／d。连续使用4d。比较两组治疗疗效与治疗前后CI、肺动脉压力以及血气分析指标变化、不良反应等。结果对照组治疗总有效率为74．00％，明显小于观察组治疗总有效率（98．00％），两组差异具有高度统计学意义（P〈0．01）；两组治疗前后CI、肺动脉压力以及血气分析指标均存在统计学差异（P〈0．05），且观察组治疗后较对照组治疗后差异具有统计学意义（P〈0．05）；两组均出现恶心、呕吐、无明显抽搐、心律失常等不良反应，但不良反应发生率差异无统计学意义（P〉0．05）。结论纳洛酮治疗慢阻肺并Ⅱ型呼吸衰竭的疗效显著，治疗前后CI、肺动脉压力以及血气分析指标变化显著，不良反应发生率低，应在临床上加以推广并应用。

Objective To study the clinical effect and safety of naloxone in the treatment of chronic respiratory failure with Ⅱ type of respiratory failure. Methods From July 2007 to July 2012 in our hospital , with the clinical pathology diagnosis 100 cases paptiens of copd with Ⅱ type of respiratory failure were randomly divided into control group and observation group, in each group was 50 cases. Control group were given anti-infection, smooth wheezing, expectorant, and correct the symptomatic treatment. On the basis, observation group were given 0.18 mg naloxone ＋ 0.9% saline 10 ml intravenous, 2 times/d, which were given continuous 4 d. Compared curative effect of two groups and CI, pulmonary artery pressure and the change of blood gas analysis index, adverse reaction before and after treatment . Results The total effective rate of control group treatment was 74.00%, total effective rate of observation group was 98.00%, there were difference statistically significant （P 〈 0.01）; before and after treatment all indexes of the two groups were statisti cal differences （P 〈 0.05）, and after treatment the observation group compared with control group after treatment, there were differences statistically significant（P 〈 0.05）; Both groups will be nausea, vomiting, no obvious adverse reactions such as convulsions, arrhythmia, but the incidence of adverse reactions, there was no statistically significant difference （P 〉 0.05）. Conclusion Naloxone treatment the curative effect of copd and I1 type of respiratory failure before and after treatment, CI indexes of blood gas analysis, pulmonary artery pressure and the change is significant, low incidence of adverse reactions, which should be popularized and applied in clinical.