盐酸纳洛酮辅助无创正压通气治疗COPD急性加重期伴呼吸衰竭的疗效观察

Observation on Therapeutic Effect of Naloxone Hydrochloride-Assisted Noninvasive Positive Pressure Ventilation on Acute Exacerbation of COPD Accompanying with Respiratory Failure

目的:探讨盐酸纳洛酮辅助无创正压通气治疗COPD急性加重期伴呼吸衰竭的疗效。方法:选取2015年7月—2018年7月我院收治的COPD急性加重期伴呼吸衰竭患者124例,按照随机数字表法分为对照组和观察组,各62例。对照组给予无创正压通气治疗,观察组给予盐酸纳洛酮注射液(2 mg加入100 mL0.9%氯化钠注射液静脉滴注,bid)辅助无创正压通气治疗,比较两组临床疗效及治疗前、后7 d血气分析的变化。结果 :观察组治疗总有效率高于对照组,差异有统计学意义(P <0.05);治疗后观察组动脉血二氧化碳分压(PaCO2)低于对照组,氧合指数(PaO2/FiO2)及动脉氧分压(PaO2)高于对照组,差异有统计学意义(P <0.05)。结论 :盐酸纳洛酮辅助无创正压通气治疗COPD急性加重期伴有呼吸衰竭的疗效较好,可有效缓解患者的临床症状,改善血气分析指标,值得临床推广应用。

Objective:To investigate the efficacy of naloxone hydrochloride-assisted noninvasive positive pressure ventilation in the treatment of acute exacerbation of COPD accompanying with respiratory failure.Methods:124 patients with acute exacerbation of COPD accompanying with respiratory failure admitted to our hospital from July 2015 to July 2018 were selected and randomly divided into a control group and an observation group,62 cases each.The patients in the control group were given noninvasive positive pressure ventilation treatment,and the patients in the observation group were given naloxone hydrochloride injection(2 mg injection was added with 100 mL saline intravenous infusion,bid)-assisted noninvasive positive pressure ventilation treatment.The clinical efficacy and blood gas analysis before and after treatment were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the partial pressure of arterial blood carbon dioxide(PaCO2)in the observation group was lower than that in the control group,while the oxygenation index(PaO2/FiO2)and the partial pressure of arterial oxygen(PaO2)were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion:Naloxone hydrochloride-assisted noninvasive positive pressure ventilation is effective in the treatment of acute exacerbation of COPD accompanying with respiratory failure,which can effectively alleviate the clinical symptoms of the patients and improve blood gas analysis indexes,which is worthy of clinical application.