尼可刹米治疗慢性阻塞性肺疾病急性加重期并呼吸衰竭的疗效观察

Clinical observation on nikethamide in treatment of chronic obstructive pulmonary disease acute exacerbation with respiratory failure

目的观察尼可刹米治疗急性加重期慢性阻塞性肺疾病(AECOPD)并呼吸衰竭的临床疗效。方法选取2013年1月—2017年1月汉中市人民医院收治的AECOPD并呼吸衰竭患者110例,随机分为对照组和治疗组,每组各55例。对照组给予无创正压通气辅助治疗。治疗组在对照组治疗基础上静脉滴注尼可刹米注射液,500 m L生理盐水溶解2.25 g尼可刹米注射液。观察两组的临床疗效,同时比较两组治疗前后血气分析指标、呼吸频率、FEV1%、m MRC评分的变化情况;比较两组气管插管率和住院时间。结果治疗后,对照组和治疗组的总有效率分别为76.36%、90.91%,两组比较差异有统计学意义(P<0.05)。治疗后,两组p O2、p H值均显著升高,p CO2显著降低,同组治疗前后差异有统计学意义(P<0.05);治疗后,治疗组p CO2均显著低于同期对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组呼吸频率、m MRC评分显著降低,FEV1%明显提高,同组治疗前后差异有统计学意义(P<0.05);治疗后,治疗组呼吸频率、m MRC评分显著低于对照组,两组比较差异具有统计学意义(P<0.05)。对照组和治疗组的气管插管率分别为29.09%、7.27%,两组比较差异有统计学意义(P<0.05)。对照组和治疗组平均住院时间比较差异有统计学意义(P<0.05)。结论尼可刹米治疗AECOPD并呼吸衰竭具有较好的临床疗效,可显著改善患者的血气指标,降低m MRC评分、插管率和住院时间,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of nikethamide in treatment of chronic obstructive pulmonary disease acute exacerbation（AECOPD） with respiratory failure. Methods Patients（110 cases） with AECOPD with respiratory failure in Hanzhong People＇s Hospital from January 2013 to January 2017 were randomly divided into control（55 cases） and treatment（55 cases） groups. Patients in the control group were iv administered with non-invasive positive pressure ventilation. Patients in the treatment group were iv administered with Nikethamide Injection on the basis of the control group, and 2.25 g Nikethamide Injection was dissolved with 500 mL physiological saline. After treatment, the clinical efficacy was evaluated, and the changes of blood gas analysis indexes, respiratory frequency, FEV1%, m MRC scores in two groups before and after treatment were compared. Tracheal intubation rate and hospitalization time in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 76.36% and 90.91%, respectively, and there was difference between two groups（P〈0.05）. After treatment, p O2 and pH in two groups were elevated, and p CO2 was reduced, and the difference was statistically significant in the same group（P〈0.05）. After treatment, p CO2 in the treatment group was lower than those in the control group at the same times of the treatment, and there was difference between two groups（P〈0.05）. After treatment, respiratory frequency and m MRC scores in two groups were reduced, and FEV1% was elevated, and the difference was statistically significant in the same group（P〈0.05）. After treatment, frequency and m MRC scores in the treatment group were lower than those in the control group, and there was difference between two groups（P〈0.05）. The tracheal intubation rates of control and treatment groups was 29.09% and 7.27%, respectively, and there was difference between two groups（P〈0.05）. The average hospitalization times in the control and the treatment groups were difference between two groups（P〈0.05）. Conclusion Nikethamide has clinical curative effect in treatment of AECOPD with respiratory failure, and can significantly improve the blood gas indexes, reduce m MRC scores, and also and reduce intubation rate and hospitalization time, which has a certain clinical application value.