纳洛酮联合纤维支气管镜治疗Ⅱ型呼吸衰竭患者的效果

Effects of Naloxone combined with fiberoptic bronchoscopy in treatment of patients with type Ⅱ respiratory failure

目的:探讨纳洛酮联合纤维支气管镜治疗Ⅱ型呼吸衰竭患者的效果。方法:选取2020年10月至2021年11月该院收治的72例Ⅱ型呼吸衰竭患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各36例。两组入院后均给予抗感染、解痉、吸痰、机械通气等常规治疗,对照组在此基础上给予纤维支气管镜吸痰、灌洗治疗,观察组在对照组基础上联合纳洛酮治疗。比较两组血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、pH值]水平、呼吸力学指标[气道平台压(PP)、吸气峰压(PIP)及平均气道压(PM)]水平、肺功能指标[肺总量(TLC)、第1秒用力呼气容积(FEV_(1))]水平,以及不良事件发生率。结果:治疗后,观察组PaO_(2)水平、pH值、TLC、FEV_(1)水平均高于对照组,PaCO_(2)、PP、PIP、PM水平均低于对照组,差异有统计学意义(P<0.05);两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论:纳洛酮联合纤维支气管镜治疗Ⅱ型呼吸衰竭患者,可改善血气指标水平、呼吸力学指标水平,提高肺功能,效果优于单用纤维支气管镜治疗,且安全性良好。

Objective:To explore effects of Naloxone combined with fiberoptic bronchoscopy in treatment of patients with type Ⅱ respiratory failure.Methods:72 patients with SP and RF who were admitted to our hospital from October 2020 to November 2021 were selected for the prospective study,and were divided into observation group and control group according to the random number table method,36 cases in each.After admission,the two groups were given conventional treatments such as anti-infection,antispasmodic,sputum suction,and mechanical ventilation.On this basis,the control group was treated with fiberoptic bronchoscopy sputum suction and lavage,while the observation group was treated with Naloxone on the basis of that of the control group.The blood gas index levels[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))、pH value],the respiratory mechanics index levels[airway plateau pressure(PP),peak inspiratory pressure(PIP)and mean airway pressure(PM)],the pulmonary function indicator levels[total lung capacity(TLC),forced expiratory volume in 1 second(FEV_(1))],and the incidence of adverse events were compared between the two groups.Results:After the treatment,the levels of PaO_(2),pH,TLC,and FEV_(1) in the observation group were higher than those in the control group;the levels of PaCO_(2),PP,PIP,and PM in the observation group were lower than those in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusions:Naloxone combined with fiberoptic bronchoscopy in the treatment of the patients with type II respiratory failure can improve the blood gas index levels,the respiratory mechanics index levels,and the pulmonary function indicator levels with good safety.