多沙普仑联合经鼻高流量氧疗在COPD合并轻度高碳酸血症治疗中的效果  

Effect of doxapram combined with nasal high-flow oxygen therapy in the treatment of chronic obstructive pulmonary disease(COPD)complicated with mild hypercapnia

作　　者：朱伟 鲁青芳 崔文旺 ZHU Wei;LU Qingfang;CUI Wenwang(Department of Emergency,Affiliated Taihe Traditional Chinese Medicine Hospital,Anhui University of Traditional Chinese Medicine,Fuyang Anhui 236699,China)

机构地区：[1]安徽省中医药大学附属太和中医院急诊科,安徽阜阳236699

出　　处：《新疆医科大学学报》2024年第8期1124-1128,共5页Journal of Xinjiang Medical University

基　　金：安徽省自然科学基金(2208085QH264)。

摘　　要：目的探讨多沙普仑联合经鼻高流量氧疗在慢性阻塞性肺疾病(COPD)合并轻度高碳酸血症治疗中的效果。方法选取2023年1月至2023年7月本院收治的COPD合并轻度高碳酸血症患者96例,采用随机数表法将其分为对照组和研究组,每组各48例。两组均给予基础治疗,对照组另给予经鼻高流量氧疗,研究组另给予多沙普仑联合经鼻高流量氧疗治疗。对比两组患者肺功能、血气指标及临床疗效。对比两组患者肺表面活性蛋白(SP-D)、Clara细胞分泌蛋白(CC16)水平及Bathel指数(BI)评分。对比两组患者不良反应发生情况。结果治疗后研究组第1秒用力呼气容积(FEV1)[(1.28±0.25)L vs(1.12±0.21)L]、用力肺活量(FVC)[(2.28±0.3)L vs(2.07±0.35)L]及FEV1/FVC[(56.14±5.12)%vs(54.11±4.78)%]均高于对照组(P<0.05)。治疗后研究组动脉血氧分压(PaO:-2)[(67.21±8.16)mmHg vs(58.43±7.65)mmHg]、血氧饱和度(SpO:-2)[(90.62±8.65)%vs(86.74±7.92)%]均高于对照组(P<0.05),动脉二氧化碳分压(PaCO:-2)[(40.53±2.70)mmHg vs(42.85±2.86)mmHg]低于对照组(P<0.05)。研究组治疗总有效率(93.75%vs 79.17%)高于对照组(χ^(2)=4.360,P=0.037)。两组治疗后SP-D水平[(38.12±9.53)mg/mL vs(40.18±9.85)mg/mL]、CC16水平[(86.14±9.25)ng/mL vs(84.33±9.07)ng/mL]差异无统计学意义(t=1.095、0.968,P=0.276、0.336)。治疗后研究组BI评分[(73.88±6.16)分vs(71.23±5.94)分]高于对照组(t=2.145,P=0.034)。两组患者不良反应总发生率(14.58%vs 10.42%)相近(χ^(2)=0.381,P=0.537)。结论多沙普仑联合经鼻高流量氧疗治疗COPD合并轻度高碳酸血症可提高患者肺功能,改善血气指标,提高临床疗效,提高患者生活质量,且安全可靠。Objective:To investigate the effect of doxapram combined with nasal high flow oxygen therapy in the treatment of chronic obstructive pulmonary disease(COPD)with mild hypercapnia.Methods:96 patients with COPD complicated with mild hypercapnia admitted to the hospital from January 2023 to July 2023 were selected as the study objects.All of the patients were divided into control group and study group by random number table method,48 cases in each group.Both groups were given basic treatment,the control group was given high-flow nasal cannula oxygen therapy,and the study group was given doxapram combined with high-flow nasal cannula oxygen therapy.Pulmonary function,blood gas index and clinical efficacy were compared between the 2 groups.The levels of pulmonary surfactant protein(SP-D),Clara cell secretory protein(CC16)and Bathel index(BI)score were compared between the 2 groups.The incidence of adverse reactions was compared between the 2 groups.Results:After the treatment,the forced expiratory volume in 1 second(FEV1)[(1.28±0.25)L vs(1.12±0.21)L],forced vital capacity(FVC)[(2.28±0.3)L vs(2.07±0.35)L]and FEV1/FVC[(56.14±5.12)%vs(54.11±4.78)%]in the study group were higher than those in the control group(P<0.05).After the treatment,the arterial partial pressure of oxygen(PaO:-2)[(67.21±8.16)mmHg vs(58.43±7.65)mmHg]and blood oxygen saturation(SpO:-2)[(90.62±8.65)%vs(86.74±7.92)%]in the study group were higher than those in the control group(P<0.05),and the arterial partial pressure of carbon dioxide(PaCO:-2)[(40.53±2.70)mmHg vs(42.85±2.86)mmHg]was lower than those in the control group(P<0.05).The total effective rate of the study group(93.75%vs 79.17%)was higher than that of the control group(χ^(2)=4.360,P=0.037).After the treatment,there were no statistically significant differences in SP-D levels[(38.12±9.53)mg/mL vs(40.18±9.85)mg/mL]and CC16 levels[(86.14±9.25)ng/mL vs(84.33±9.07)ng/mL]between the 2 groups(t=1.095,0.968,P=0.276,0.336).After the treatment,the BI score of the study group[(73.88±6.16

关 键 词：慢性阻塞性肺疾病 轻度高碳酸血症 多沙普仑 经鼻高流量氧疗 临床疗效 肺功能 

分 类 号：R453.2[医药卫生—治疗学]