纳洛酮治疗COPD呼吸衰竭肺性脑病的疗效分析  

Analysis of the therapeutic effect of naloxone in the treatment of COPD with respiratory failure and pulmonary encephalopathy

作　　者：张勉 ZHANG Mian(Tengzhou Traditional Chinese Medicine Hospital,Zaozhuang 277599,China)

机构地区：[1]滕州市中医医院,277599

出　　处：《中国现代药物应用》2024年第12期6-10,共5页Chinese Journal of Modern Drug Application

摘　　要：目的探讨在慢性阻塞性肺疾病(COPD)呼吸衰竭肺性脑病的治疗中采用纳洛酮的应用效果。方法选取78例COPD呼吸衰竭肺性脑病患者,采用随机数字表法分为对照组[n=39,采取经鼻面罩双水平气道正压通气呼吸机(BiPAP)无创呼吸正压通气治疗]与研究组(n=39,在对照组基础上联合使用纳洛酮治疗)。对比两组治疗效果,血气指标[血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))],肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC],临床指标(呼吸衰竭纠正时间、感染控制窗出现时间、呼吸机使用时间、气管插管率及住院时间),炎性因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)]。结果研究组治疗总有效率94.87%较对照组的74.36%高(P<0.05)。治疗后,研究组SpO_(2)(98.36±6.01)%、PaO_(2)(70.63±4.51)mm Hg(1 mm Hg=0.133 kPa)较对照组的(94.31±5.28)%、(61.21±4.23)mm Hg高,PaCO_(2)(46.24±2.42)mm Hg较对照组的(54.02±2.63)mm Hg低(P<0.05)。治疗后,研究组FEV1(3.21±0.57)L、FVC(3.59±0.24)L、FEV1/FVC(74.36±5.34)%较对照组的(2.34±0.63)L、(3.05±0.43)L、(68.24±4.12)%高(P<0.05)。研究组呼吸衰竭纠正时间、感染控制窗出现时间、呼吸机使用时间、住院时间分别为(1.53±0.37)、(4.76±0.54)、(6.31±0.65)、(9.34±1.03)d,均较对照组的(2.54±0.65)、(6.55±0.84)、(8.81±1.05)、(14.52±1.13)d短,气管插管率5.13%较对照组的23.08%低(P<0.05)。治疗后,研究组IL-6(20.14±2.06)ng/L、CRP(6.65±0.71)mg/L、PCT(1.31±0.26)ng/ml较对照组的(23.04±2.13)ng/L、(8.23±0.87)mg/L、(1.62±0.34)ng/ml低(P<0.05)。结论在COPD呼吸衰竭肺性脑病患者的治疗中采用纳洛酮能够降低机体炎性反应,改善患者的血气指标及肺功能,有效缓解患者的临床症状,减少气管插管率,可促进患者病情好转。Objective To explore the practical effect of naloxone in the treatment of chronic obstructive pulmonary disease(COPD)with respiratory failure and pulmonary encephalopathy.Methods 78 COPD patients with respiratory failure and pulmonary encephalopathy were selected and randomly divided into a control group[n=39,treated with bi-level positive airway pressure ventilation(BiPAP)non-invasive positive pressure ventilation via nasal mask]and a study group(n=39,treated with naloxone in addition to the control group)using a random number table method.Both groups were compared in terms of treatment effect,blood gas indicators[blood oxygen saturation(SpO_(2)),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],lung function indicators[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC],clinical indicators(respiratory failure correction time,infection control window appearance time,ventilator use time,tracheal intubation rate and hospital stay),and inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT)].Results The total effective rate of the study group was 94.87%,which was higher than 74.36%of the control group(P<0.05).After treatment,the study group had SpO_(2) of(98.36±6.01)%and PaO_(2) of(70.63±4.51)mm Hg(1 mm Hg=0.133 kPa),which were higher than(94.31±5.28)%and(61.21±4.23)mm Hg in the control group;the study group had lower PaCO_(2) of(46.24±2.42)mm Hg than(54.02±2.63)mm Hg in the control group(P<0.05).After treatment,the study group had FEV1 of(3.21±0.57)L,FVC of(3.59±0.24)L and FEV1/FVC of(74.36±5.34)%,which were higher than(2.34±0.63)L,(3.05±0.43)L and(68.24±4.12)%in the control group(P<0.05).In the study group,the respiratory failure correction time,infection control window appearance time,ventilator use time,and hospital stay were(1.53±0.37),(4.76±0.54),(6.31±0.65)and(9.34±1.03)d,which were shorter than(2.54±0.65),(6.55±0.84),(8.81±1.05)and(14.52±1.13)d in the control group;the study group

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 肺性脑病 纳洛酮 血气指标 治疗效果 

分 类 号：R563.8[医药卫生—呼吸系统] R747.9[医药卫生—内科学] R563.9[医药卫生—临床医学]