不同呼吸兴奋剂联合无创通气用于慢性阻塞性肺疾病并发呼吸衰竭的疗效  

Effects of different respiratory stimulants combined with noninvasive ventilation on chronic obstructive pulmonary disease complicated with respiratory failure

作　　者：林魏魏 赵晓培 LIN Weiwei;ZHAO Xiaopei(Department of Emergency and Critical Diseases,Henan Staff Hospital,Zhengzhou 450000,Henan,China)

机构地区：[1]河南省职工医院急危重症科,河南郑州450000

出　　处：《右江医学》2022年第4期286-290,共5页Chinese Youjiang Medical Journal

摘　　要：目的分析不同呼吸兴奋剂联合无创通气治疗慢性阻塞性肺疾病(COPD)并发呼吸衰竭的疗效。方法选取2018年2月至2020年9月收治的COPD并发呼吸衰竭患者96例,按随机数字表分为多沙普仑组(n=48)和尼可刹米组(n=48),尼可刹米组予以尼可刹米联合无创通气,多沙普仑组予以多沙普仑联合无创通气。比较两组疗效、不良反应发生率及治疗前后呼吸力学指标[潮气量(TV)、呼吸频率(RR)]、肺功能[第一秒呼气量容积(FEV_(1))、用力肺活量(FVC)]、血气指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))]变化。结果多沙普仑组总有效率(91.67%)高于尼可刹米组(77.08%),差异有统计学意义(P<0.05)。治疗前,两组TV、RR水平对比差异无统计学意义(P>0.05);治疗后,多沙普仑组TV水平高于尼可刹米组,RR水平低于尼可刹米组(P<0.01)。治疗前,两组FEV_(1)、FVC水平对比差异无统计学意义(P>0.05);治疗后,多沙普仑组FEV_(1)、FVC水平高于尼可刹米组(P<0.05或0.01)。治疗前,两组PaO_(2)、PaCO_(2)水平对比差异无统计学意义(P>0.05);治疗后,多沙普仑组PaO_(2)水平高于尼可刹米组,PaCO_(2)水平低于尼可刹米组(P<0.001)。多沙普仑组总不良反应发生率(12.50%)与尼可刹米组(14.58%)对比差异无统计学意义(P>0.05)。结论多沙普仑联合无创通气治疗COPD并发呼吸衰竭患者,可提高疗效,改善呼吸力学指标,提高肺功能,恢复血气水平,且安全性良好。Objective To analyze the efficacy of different respiratory stimulants combined with noninvasive ventilation on chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods A total of 96 COPD patients complicated with respiratory failure admitted to hospital from February 2018 to September 2020 were selected and divided into doxapram group(n=48)and nikethamide group(n=48)according to random number table.The nikethamide group were given nikethamide combined with noninvasive ventilation,and the doxapram group were given doxapram combined with noninvasive ventilation.And then,the curative effects,incidence of adverse reactions as well as the changes of respiratory mechanics indexes(tidal volume[TV],respiratory rate[RR]),lung functions(forced expiratory volume in one second[FEV_(1)],forced vital capacity[FVC])and blood gas indexes(partial pressure of oxygen[PaO_(2)],partial pressure of carbon dioxide in artery[PaCO_(2)])before and after treatment were compared between the two groups.Results The total effective rate of the doxapram group was 91.67%,which was higher than that of the nikethamide group(77.08%),and difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in TV and RR levels between the two groups(P>0.05).After treatment,the TV level of the doxapram group was higher than that of the nikethamide group,and the RR level was lower than that of the nikethamide group,and the difference was statistically significant(P<0.01).Before treatment,there was no statistically significant difference in FEV_(1) and FVC levels between the two groups(P>0.05).After treatment,the levels of FEV_(1) and FVC in the doxapram group were higher than those in the nikethamide group(P<0.05 or 0.01).Before treatment,there was no statistically significant difference in PaO_(2) and PaCO_(2) levels between the two groups(P>0.05).After treatment,the level of PaO_(2) in the doxapram group was higher than that in the nikethamide group,and the level of PaCO_(2)

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 尼可刹米 无创通气 多沙普仑 

分 类 号：R563[医药卫生—呼吸系统]