纳洛酮联合双水平气道正压通气治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭  

BiPAP Combined with Naloxone for Acute Exacerbation of Chronic Obstructive Pulmonary Disease Associated with Type Ⅱ Respiratory Failure

作　　者：徐德华[1] 

机构地区：[1]惠州市中医医院呼吸内科,广东惠州516001

出　　处：《实用临床医学（江西）》2011年第11期25-27,共3页Practical Clinical Medicine

摘　　要：目的探讨纳洛酮联合双水平气道正压通气治疗治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭的临床疗效。方法将75例AECOPD合并Ⅱ型呼吸衰竭患者按随机数字表法分为治疗组(n=40)和对照组(n=35)。2组患者均予以吸氧、抗感染、止咳化痰、平喘等常规治疗。对照组在常规治疗基础上加用双水平气道正压通气的无创正压呼吸机治疗,选用S/T模式,同时给氧;治疗组在对照组治疗基础上联合纳络酮治疗。对2组患者的疗效、生命体征,治疗前及治疗后12、24、72h动脉血气分析进行比较。结果 2组患者治疗后pH、PaCO2、PaO2、心率及呼吸频率较治疗前均有明显改善,而治疗组在降低PaCO2、呼吸频率和提高PaO2等方面较对照组更明显(均P<0.01);治疗组总有效率为92.5%,对照组总有效率为71.4%,2组比较差异有统计学意义(P<0.05)。结论纳洛酮联合双水平气道正压通气是治疗AECOPD合并Ⅱ型呼吸衰竭安全、有效的方法。Objective To investigate the clinical curative effect of Bi-level positive airway pressure（BiPAP） ventilation plus naloxone on acute exacerbation of chronic obstructive pulmonary disease（AECOPD） associated with type Ⅱrespiratory failure.Methods Seventy-five patients with AECOPD associated with type Ⅱrespiratory failure were randomly divided into two groups.All patients received routine treatment with oxygen inhalation,anti-infection,facilitating expectoration,suppressing cough and relieving dyspnea.On the basis of conventional therapy,control group（n=35） was given BiPAP in the S/T mode and treatment group（n=40） was given naloxone.The curative effect,vital signs and arterial blood gas analysis before and 12,24 and 72 hours after treatment were compared between the two groups.Results There were significant improvements in PH,PaCO2,PaO2,heart rate and respiratory rate after treatment in both groups,and the improvements in PaCO2,PaO2 and respiratory rate in treatment group were more obvious than those in control group（P0.01）.In addition,the total effective rate in treatment group was significantly higher than that in control group（92.5% vs 71.4%,P0.05）.Conclusion BiPAP ventilation combined with naloxone is a safe and effective treatment for AECOPD associated with type Ⅱrespiratory failure.

关 键 词：慢性阻塞性肺疾病急性加重期 Ⅱ型呼吸衰竭 双水平气道正压通气 纳洛酮 

分 类 号：R568[医药卫生—呼吸系统]