鼻面罩无创正压通气联合呼吸兴奋剂治疗慢性阻塞性肺疾病合并呼吸衰竭及肺性脑病的临床疗效观察  

Clinical Effect of Nasal Mask Non-invasive Positive Pressure Ventilation Combined with Respiratory Stimulant on COPD Complicated with Respiratory Failure and Pulmonary Encephalopathy

作　　者：龚年金 

机构地区：[1]湖北省恩施土家族苗族自治州中心医院肺科,445000

出　　处：《实用心脑肺血管病杂志》2015年第4期23-25,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的观察鼻面罩无创正压通气(NIPPV)联合呼吸兴奋剂治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭及肺性脑病的临床疗效。方法选择湖北省恩施土家族苗族自治州中心医院2012年1月—2014年1月收治的COPD合并呼吸衰竭及肺性脑病住院患者120例,随机分为观察组与对照组,每组60例。对照组患者在常规治疗基础上给予鼻面罩NIPPV治疗,观察组患者在常规治疗基础上给予鼻面罩NIPPV联合呼吸兴奋剂(尼可刹米和洛贝林)治疗。比较两组患者治疗有效率、气管插管率、人机同步率、并发症发生率及通气治疗前、通气治疗3 h、通气治疗结束后动脉血气指标变化。结果观察组患者治疗有效率和人机同步率高于对照组,气管插管率和胃胀气发生率低于对照组(P<0.05)。通气治疗前、通气治疗3 h及通气治疗结束后两组患者p H值、动脉血氧分压(Pa O2)及动脉血二氧化碳分压(Pa CO2)比较,差异均无统计学意义(P>0.05)。结论鼻面罩NIPPV联合呼吸兴奋剂治疗COPD合并呼吸衰竭及肺性脑病安全有效,且可以降低患者气管插管率及并发症发生率。Objective To investigate the clinical effect of nasal mask non - invasive positive pressure ventilation （ NIPPV） combined with respiratory stimulant on COPD complicated with respiratory failure and pulmonary encephalopathy. Methods From January 2012 to January 2014,a total of 120 COPD patients complicated with respiratory failure and pulmonary encephalopathy were selected in the Central Hospital of Enshi Autonomous State of Tujia and Miao Nationality,and they were randomly divided into observation group and control group,each of 60 cases. Patients of both groups were given conventional＆amp;nbsp;treatment and nasal mask NIPPV,and patients of observation group were given extra respiratory stimulant including nikethamide and lobeline. The effective rate,endotracheal intubation rate,patient-ventilator synchrony rate,incidence of complications and arterial blood gas index before treatment,3 hours after ventilation,at the end of ventilation were compared between the two groups. Results The effective rate,patient-ventilator synchrony rate of observation group were higher than those of control group,while endotracheal intubation rate and incidence of gastric distension of observation group were lower than those of control group（P﹤0. 05）. No statistically significant differences of pH,PaO2 and PaCO2 were found between the two groups before treatment,3 hours after ventilation,at the end of ventilation（P ﹥0. 05）. Conclusion Nasal mask NIPPV combined with respiratory stimulant is effective and safe in treating COPD complicated with respiratory failure and pulmonary encephalopathy, which can reduce the endotracheal intubation rate and incidence of complications.

关 键 词：肺疾病 慢性阻塞性 呼吸功能不全 肺性脑病 无创正压通气 呼吸系统药 

分 类 号：R563.9[医药卫生—呼吸系统]