纳洛酮联合纤维支气管镜灌洗治疗Ⅱ型呼吸衰竭的临床疗效  

Clinical efficacy of naloxone combined with fiberoptic bronchoscopic lavage in the treatment of typeⅡrespiratory failure

作　　者：林丛 陈志梁 李汝灿 LIN Cong;CHEN Zhiliang;LI Rucan(Department of Respiratory Medicine,Funeng Group General Hospital,Fuzhou 350000,China)

机构地区：[1]福能集团总医院呼吸内科,福州市350000

出　　处：《临床合理用药杂志》2023年第27期8-11,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察纳洛酮联合纤维支气管镜灌洗治疗Ⅱ型呼吸衰竭的临床疗效。方法选取2020年6月-2022年5月福能集团总医院收治的70例Ⅱ型呼吸衰竭患者,按照随机数字表法分为灌洗组与联合用药组,各35例。灌洗组采用纤维支气管镜灌洗治疗,联合用药组在灌洗组基础上联合纳洛酮治疗,2组均治疗3 d。比较2组治疗前与治疗3 d后肺功能指标[肺总量(TLC)、第1秒用力呼气容积(FEV_(1))]、呼吸力学指标[吸气峰压(PIP)、气道平台压(Pp)以及平均气道压(Pm)]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、pH值]、胸与肺顺应性指标[肺顺应性(CL)、胸廓顺应性(Ccw)以及呼吸系统总顺应性(Crs)]及不良反应。结果治疗3 d后,2组TLC、FEV_(1)、PaO_(2)、pH值高于治疗前,PIP、Pp、Pm、PaCO_(2)低于治疗前,且联合用药组升高/降低幅度大于灌洗组(P<0.01);2组CL、Ccw、Crs高于治疗前,且联合用药组高于灌洗组(P<0.01)。联合用药组不良反应总发生率低于灌洗组(5.71%vs.25.71%,χ^(2)=5.285,P=0.022)。结论纳洛酮联合纤维支气管镜灌洗治疗Ⅱ型呼吸衰竭的疗效显著,可明显改善患者肺功能,提高胸、肺顺应性,增加血氧含量,纠正机体酸碱失衡,且安全性较高。Objective To observe the clinical efficacy of naloxone combined with fiberoptic bronchoscopic lavage in the treatment of typeⅡrespiratory failure.Methods A total of 70 cases of patients with typeⅡrespiratory failure admitted to the Funeng Group General Hospital,from June 2020 to May 2022 were selected,and they were divided into the lavage group and the combination group according to the random number table method,with 35 cases in each group.The lavage group was treated with fiberoptic bronchoscopy lavage,and the combination group was treated with naloxone on the basis of the lavage group,and both groups were treated for 3 days.Pulmonary function indexes(TLC,FEV_(1)),respiratory mechanics indexes(PIP,Pp,Pm),blood gas indexes(PaO_(2),PaCO_(2),pH value),chest and pulmonary compliance indexes(CL,Ccw,Crs)before and after 3 days of treatment,and adverse reactions were compared between the two groups.Results After 3 days of treatment,TLC,FEV_(1),PaO_(2)and pH value in the two groups were higher than those before treatment,PIP,Pp,Pm and PaCO_(2)were lower than those before treatment,and the increased/decreased of indexes in the combination group were greater than those in the lavage group(P<0.01);CL,Ccw and Crs of the two groups were higher than those before treatment,and the combination group were higher than those of the lavage group(P<0.01).The overall incidence of adverse reactions in the combination group was lower than that in the lavage group(5.71%vs.25.71%,χ^(2)=5.285,P=0.022).Conclusion The efficacy of naloxone combined with fiberoptic bronchoscopic lavage is significant in the treatment of typeⅡrespiratory failure,which can significantly improve the patients′pulmonary function,increase chest and pulmonary compliance,increase blood oxygen and correct the acid-base imbalance of the body,and with higher safety.

关 键 词：Ⅱ型呼吸衰竭 纳洛酮 纤维支气管镜 灌洗治疗 肺功能 胸肺顺应性 治疗结果 

分 类 号：R563.8[医药卫生—呼吸系统]