纳洛酮联合无创呼吸机治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭的临床效果观察

Clinical effects of naloxone and noninvasive ventilator in treatment of AECOPD combined with type Ⅱ respiratory failure

目的观察纳洛酮联合无创呼吸机治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭的临床效果。方法将2016年3月‐2017年2月治疗的82例AECOPD合并Ⅱ型呼吸衰竭患者作为研究对象,将其依照随机数表法分为两组,各41例。对照组实施常规治疗,观察组则加以纳洛酮、无创呼吸机治疗。观察两组临床疗效、不良反应、治疗前后血气指标变化情况。结果两组治疗总有效率、急性加重发生率相比,观察组均优于对照组,差异有统计学意义(P <0.05);两组不良反应发生率对比,差异无统计学意义(P>0.05);治疗前两组二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、酸碱度(PH)、心率、呼吸频率对比,差异无统计学意义(P>0.05);治疗后观察组PaO2、PH高于对照组,PaCO2低于对照组,差异有统计学意义(P <0.05)。结论将纳洛酮与无创呼吸机联合治疗AECOPD合并Ⅱ型呼吸衰竭效果确切,利于改善患者血气指标与不良症状,降低急性加重发作风险,安全性良好。

【Objective】To observe the clinical effects of naloxone and noninvasive ventilator in treatment of acute exacerbation of chronic obstructive pulmonary disease（AECOPD） combined with type Ⅱ respiratory failure.【Methods】Eightytwo patients with AECOPD combined with type Ⅱ respiratory failure treated from March 2016 to February 2017 were selected, and they were divided into two groups by random number table, 41 cases in each group. Control group was given routine treatment, while observation group was treated with naloxone and noninvasive ventilator. The clinical efficacy, adverse reactions, changes of blood gas indexes in the two groups were observed.【Results】The total effective rate and the incidence of acute exacerbation in observation group were better than those in control group（P 0.05）; there was no statistical difference in the incidence of adverse reactions between the two groups（P 0.05）; before treatment, there was no statistical difference in the partial pressure of carbon dioxide（PaCO2）, arterial oxygen pressure（PaO2）, power of hydrogen（PH）, heart rate, and respiratory rate between the two groups（P 0.05）; after treatment, the PaO2 and PH in observation group were higher than those in control group, while PaCO2 was lower in observation group than in control group（P 0.05）.【Conclusion】Naloxone and noninvasive ventilator in treatment of AECOPD combined with type Ⅱ respiratory failure is effective, and it can improve blood gas indexes and adverse symptoms, decrease the incidence of acute exacerbation and have good safety.