机械通气联合纳洛酮对急性呼吸衰竭的疗效及安全性分析

Effect of Mechanical Ventilation Combined with Naloxone on Acute Respiratory Failure and Its Safety

目的探讨机械通气联合纳洛酮治疗急性呼吸衰竭的效果以及评估安全性。方法方便选取该院2012年1月—2017年12月收治的50例急性呼吸衰竭患者,随机分为治疗组和对照组,每组25例,治疗组给予机械通气联合纳洛酮治疗,对照组给予机械通气治疗,比较两组治疗后指标及不良反应发生率。结果治疗组治疗后平均心率、收缩压、舒张压、呼吸频率分别为(80.3±4.5)次/min、(117.3±4.7)mm Hg、(70.2±4.3)mm Hg、(16.2±2.5)次/min,低于对照组(94.3±4.8)次/min、(128.3±5.7)mm Hg、(80.1±5.3)mm Hg、(21.2±3.5)次/min,差异有统计学意义(t=10.639 0、7.444 6、7.2527、5.812 3,P=0.000 0、0.000 0、0.000 0、0.000 0<0.05)。治疗组治疗后第1秒用力呼气容积、肺一氧化碳弥散量分别为(3.3±0.2)L、(67.5±4.6)%,低于对照组(3.9±0.1)L、(74.5±5.3)%,差异有统计学意义(t=13.416 4、4.987 2,P=0.000 0、0.000 0<0.05)。治疗组治疗后p H值、动脉血气血分压、二氧化碳分压、血氧饱和度分别为(7.41±0.04)、(100.3±5.5)mm Hg、(33.3±4.3)mm Hg、(97.3±3.2)%,对照组(7.40±0.02)、(89.3±5.6)mm Hg、(43.3±5.8)mm Hg、(91.3±3.5)%,两组间p H值差异无统计学意义(t=1.118 0,P=0.269 1>0.05),其他血气指标均差异有统计学意义(t=7.007 0、6.925 1、6.325 9,P=.000 0、0.000 0、0.000 0<0.05)。治疗组不良反应发生率(4.0%)低于对照组(24.0%)(χ2=4.152 8,P=0.041 5<0.05)。结论机械通气联合纳洛酮治疗急性呼吸衰竭,能够缓解患者临床症状,值得临床推广。

Objective This paper tries to investigate the effect of mechanical ventilation and naloxone in the treatment of acute respiratory failure and to evaluate the safety. Methods 50 patients with acute respiratory failure who were convenient selected in this hospital between January 2012 and December 2017 were randomly divided into treatment group and control group, with 25 cases in each group. The treatment group was given mechanical ventilation combined with naloxone, and the control group was given mechanical ventilation treatment, to compare the post-treatment indicators and the incidence of adverse reactions between the two groups. Results The average heart rate, systolic blood pressure, diastolic blood pressure,and respiratory frequency in the treatment group were（80.3 ±4.5）times/min,（117.3 ±4.7）mm Hg,（70.2 ±4.3）mm Hg, and（16.2±2.5） times/min, respectively, which were lower than the control group＇s（94.3±4.8）times/min（128.3±5.7）mm Hg,（80.1±5.3）mm Hg,（21.2±3.5）times/min. The differences were statistically significant（t=10.639 0, 7.444 6, 7.252 7, 5.812 3,P=0.000 0, 0.000 0, 0.000 0, 0.000 00.05）. In the treatment group, the forced expiratory volume in the first second and the diffusion amount of carbon monoxide in the lung were（3.3±0.2）L and（67.5±4.6）%, respectively, which were lower than the（3.9±0.1）L and（74.5±5.3）% in the control group. The difference was statistically significant（t=13.416 4, 4.987 2, P=0.000 0, 0.000 0 0.05）. After treatment, the p H value, arterial blood gas partial pressure, carbon dioxide partial pressure,and blood oxygen saturation in the treatment group were（7.41±0.04）,（100.3±5.5）mm Hg,（33.3 ±4.3）mm Hg, and（97.3 ±3.2）%, respectively, and the control group was（7.40±0.02）mm Hg and（89.3 ±5.6）mm Hg,（43.3±5.8）mm Hg, and（91.3±3.5）%.There was no significant difference in p H between the two groups（t =1.118 0, P =0.269 1 0.05）. The difference in other blood gas parameters was statistically significant（t=7.007 0, 6.925 1, 6.325 9, P=0.000 0, 0.000 0, 0.000 0 0.05）. The incidence of adverse reactions in the treatment group（4.0%） was lower than that in the control group（24.0%）（χ2= 4.152 8,P=0.041 5 0.05）. Conclusion Mechanical ventilation combined with naloxone in the treatment of acute respiratory failure can relieve clinical symptoms and is worthy of clinical promotion.