| 无创正压通气联合纳洛酮治疗慢性阻塞性肺疾病急性加重期并发呼吸衰竭的耐受性及安全性分析 |
| 投稿时间：2014-09-30 修订日期：2014-11-28 点此下载全文 |
| 引用本文：张遂甫,陈晓平,陈永生,包磊,张腾.无创正压通气联合纳洛酮治疗慢性阻塞性肺疾病急性加重期并发呼吸衰竭的耐受性及安全性分析[J].医学研究杂志,2015,44(6):151-154 |
| DOI：
10.11969/j.issn.1673-548X.2015.06.043 |
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| 中文摘要:目的 评价无创正压机械通气(NPPV)联合纳洛酮(NLX)治疗慢性阻塞性肺疾病急性加重期(AECOPD)并发Ⅱ型呼吸衰竭的耐受性及安全性。方法 将85例因AECOPD伴有Ⅱ型呼吸衰竭进行NPPV治疗的住院患者采用数字表法随机分为观察组42例和对照组43例,对照组给予临床常规治疗和NPPV治疗,观察组在对照组的基础上应用NLX治疗;监测两组治疗前后动脉血气分析、呼吸频率、心率的变化以及气管插管率、辅助呼吸肌评分及NPPV不耐受放弃的例数。结果 与治疗前比较,两组治疗后PaCO2下降、PaO2上升、pH值上升,同时患者呼吸频率、心率减慢,差异有统计学意义(P<0.05)。与对照组比较,观察组NPPV治疗后24h各项指标改善较明显(P<0.05)。观察组气管插管率、辅助呼吸肌评分及NPPV不耐受放弃的例数均明显低于对照组,差异有统计学意义(P<0.05)。结论 NPPV联合NLX治疗AECOPD并发Ⅱ型呼吸衰竭可显著改善患者血气分析指标,降低其呼吸频率及心率,提高患者对NPPV的耐受性,并且安全性良好。 |
| 中文关键词:无创正压通气 纳洛酮 慢性阻塞性肺疾病 呼吸衰竭 |
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| Tolerance and Safety of Noninvasive Positive Pressure Ventilation and Naloxone for the Treatment of Chronic Obstructive Pulmonary Disease in Acute Exacerbation Combined with Respiratory Failure |
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| Abstract:Objective To evaluate the tolerance and safety of noninvasive positive pressure ventilation(NPPV)and naloxonfor the treatment of chronic obstructive pulmonary disease in acute exacerbation (AECOPD) combined with type Ⅱrespiratory failure. Methods Totally 85 patients with AECOPD and typeⅡrespiratory failure,using NPPV, were divided into the observation group (42 cases) and the control group (43 cases). The control group was treated with routine therapy and NPPV, wile on this basis, the observation group was given naloxone. Then the arterial blood gas,respiratory rate, heart rate, intubation,average consciousness recovery time, and number of abandoning NPPV were compared between the two groups. Results After NPPV and naloxone treatment, the levels of pH value and PaO2 increased, and the level of PaCO2 dacreased in the observation group. At the same time, the rates of respiratory and heart were lower in the observation group than in the control group with significant difference (P<0.05). The improvement of each indexes 24 hours after the treatment was more pronounced in the observation group than in the control group (P<0.05).Compared with control group, the rate of endotracheal intubation and scale for accessory muscle use and the numberof abandoning doing NPPV were obviously lower in the observation group than in the control group (P<0.05). Conclusion NPPV combined with NLX can significantly improve the blood gas analysis index in the treatment of AECOPD patients complicated with typeⅡrespiratory failure, and reduce the respiratory frequency and heart rate, and helpful to the tolera-nce of NPPV and the method is safe. |
| keywords:Noninvasive positive pressure ventilation Naloxone Chronic obstructive pulmonary diseas(COPD) Respiratory failure |
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