呼吸兴奋剂与无创正压通气联合治疗COPD合并肺性脑病的疗效探讨

Study on Curative Effect of Respiratory Stimulant Combined with Noninvasive Positive Pressure Ventilation in Treatment of COPD Combined with Pulmonary Encephalopathy

目的方便选取鼻面罩无创正压通气(NIPPV)与呼吸兴奋剂联合治疗慢性阻塞性肺疾病(COPD)合并肺性脑病的临床疗效。方法探讨该院2015年12月—2017年12月收治的90例COPD合并肺性脑病患者,根据随机数字表法均分为两组,两组均给予常规治疗,对照组加以NIPPV治疗,观察组加以尼可刹米、纳洛酮联合NIPPV治疗,比较两组临床疗效、气管插管率和治疗前后动脉血气变化。结果观察组治疗总有效率和气管插管率为86.67%、11.11%,与对照组的64.44%、40.00%比较差异有统计学意义(χ2=13.378、22.135,P<0.05);观察组治疗后的Pa CO2、Pa O2及p H分别为(48.64±5.23)mm Hg、(73.78±6.39)mm Hg、(7.58±0.23),均显著优于对照组(t=6.171、7.737、5.330,P<0.05)。结论NIPPV联合呼吸兴奋剂治疗COPF合并肺性脑病疗效确切,可显著降低患者气管插管率,改善患者血气指标。

Objective To observe the clinical curative effect of respiratory stimulant combined with noninvasive positive pressure ventilation in treatment of COPD combined with pulmonary encephalopathy. Methods 90 cases of patients with COPD combined with pulmonary encephalopathy admitted and treated in our hospital from December 2015 to December2017 were convenient selected and randomly divided into two groups, both groups used the routine therapy, the control group increased the NIPPV therapy, while the observation group increased the nikethamide, naloxone combined with NIPPV, and the clinical curative effect, tracheal intubation rate and changes of arterial blood gas were compared between the two groups. Results The total treatment effective rate and tracheal intubation rate in the observation group and in the control group were respectively 86.67%, 11.11% and 64.44%, 40.00%, and the differences were obvious（χ2=13.378,22.135, P〈0.05）; after treatment, the Pa CO2,Pa O2,p H in the observation group were respectively（48.64 ±5.23） mm Hg,（73.78 ±6.39）mm Hg,（7.58±0.23）, which were obviously better than those in the control group（t=6.171,7.737,5.330, P〈0.05）. Conclusion The curative effect of NIPPV combined with respiratory stimulant in treatment of COPD combined with pulmonary encephalopathy is definite, which can obviously reduce the tracheal intubation rate and improve the blood gas of patients.