纳洛酮联合机械通气治疗慢性阻塞性肺疾病急性加重合并急性呼吸衰竭疗效观察

Clinical effects of naloxone combined with mechanical ventilation on patients with AECOPD and acute respiration failure

目的探讨纳洛酮联合机械通气治疗慢性阻塞性肺疾病急性加重(AECOPD)合并急性呼吸衰竭(ARF)的临床效果。方法选取诊断为AECOPD合并AFR患者198例,依据治疗方式将其分为两组,观察组(101例)患者应用纳洛酮联合机械通气,对照组(97例)患者应用机械通气。比较两组患者呼吸功能指标(pH值、PaO_2、PaCO_2)、住院相关指标(通气时间、ICU时间、总住院时间)及相关预后指标(再插管率、病死率)。结果观察组患者呼吸功能改善情况、血氧饱和度维持情况、二氧化碳分压控制情况均优于对照组,差异有统计学意义(P<0.05);观察组患者通气时间和住院时间短于对照组,观察组患者再插管率和病死率低于对照组,差异有统计学意义(P<0.05)。结论纳洛酮联合机械通气治疗AECOPD合并急性呼吸衰竭,呼吸功能恢复快,预后好,值得临床推广。

Objective To investigate the clinical effects of naloxone combined with mechanical ventilation on patients with acute exacerbation of chronic obstructive pulmonary disease（ AECOPD） and acute respiration failure（ ARF）. Methods One hundred and ninety-eight patients with AECOPD combined with ARF were selected and divided into two groups according to the method of treatment,101 patients in the observation group were treated with naloxone combined with mechanical ventilation,and 97 patients in control group received traditional mechanical ventilation. The respiration function standards（ pH value,PaO_2,PaCO_2）,the in-hospital related standards（ ventilation time,ICU time,total in-hospital time） and prognosis related standards（ repeated ventilation rate,death rate） were compared between the two groups. Results The improvement of respiratory function,the maintenance of blood oxygen saturation and the control of partial pressure of PaCO_2 of the patients in observation group were better than those of the patients in the control group,the differences were significant（ P〈0. 05）; the mechanical ventilation time and the hospitalization time of the patients in the observation group were shorter than those in the control group,and the repeated ventilation rate and death rate of the patients in observation group were lower than those of the patients in the control group,the differences were significant（ P〈0. 05）. Conclusions In the treatment of AECOPD combined with ARF,naloxone combined with mechanical ventilation has better respiration function,shorter in-hospital time,which is worthy of clinical application.