无创呼吸机联合纳洛酮治疗慢性阻塞性肺疾病急性加重期AECOPD伴呼吸衰竭患者的临床疗效分析

庞随香

[摘要] 目的 探討在无创呼吸机治疗基础上应用纳洛酮治疗慢性阻塞性肺疾病急性加重期患者（AECOPD）伴有呼吸衰竭的的临床疗效。 方法 随机选取2015年1月—2017年1月期间于该院急诊科门诊进行就诊并收治入院的伴有急诊衰竭的80例AECOPD患者为研究对象，采取随机数字表法将患者随机分为对照组和观察组，对照组患者接受无创呼吸机通气治疗，观察组患者接受无创呼吸机联合纳洛酮治疗，观察并比较两组患者治疗前后治疗疗效、再插管率、住院时间、病死率以及血气指标PaO2、PaCO2、血氧饱和度等指标差异。 结果 观察组患者接受无创通气联合纳洛酮治疗后，治疗有效率为95.00%，显著高于对照组有效率87.50%（χ2=5.251，P<0.05）。观察组患者住院时间显著短于对照组，但两组患者再插管率及病死率差异无统计学意义（χ2=1.409，P>0.05；χ2=1.053，P>0.05）。此外，观察组患者PaO2、 PaCO2、血氧饱和度血气指标与血清CysC改善水平与对照组相比，差异有统计学意义（t=12.604，P<0.05；t=14.218，P<0.05；t=9.637，P<0.05；t=6.843，P<0.05）。 结论 应用无创通气联合纳洛酮治疗AECOPD合并呼吸衰竭患者，与单纯应用无创通气治疗相比，可显著提高患者治疗有效率，缩短患者住院时间，改善患者临床症状，有利于患者预后。

[关键词] 慢性阻塞性肺疾病；呼吸衰竭；无创呼吸机；纳洛酮

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）04（c）-0007-05

Analysis of Clinical Curative Effect of Noninvasive Ventilation Combined with Naloxone in Patients with AECOPD and Respiration Failure

PANG Sui-xiang

Department of Emergency， Heze Municipal Hospital， Heze， Shandong Province， 274000 China

[Abstract] Objective To study the clinical curative effect of noninvasive ventilation combined with naloxone in patients with AECOPD and respiration failure. Methods 80 cases of AECOPD patients with emergency failure admitted and treated in our hospital from January 2015 to January 2017 were randomly selected and randomly divided into two groups， the control group were treated with noninvasive ventilation， while the observation group were treated with noninvasive ventilation combined with naloxone， and the curative effect， reintubation rate， length of stay， morbidity and blood gas indexes PaO2， PaCO2， oxygen saturation of blood were compared between the two groups. Results After treatment， the treatment effective rate in the observation group was obviously higher than that in the control group，（95.00% vs 87.50%），（χ2=5.251，P<0.05）， and the length of stay in the observation group was obviously shorter than that in the control group， and the differences in the reintubation rate and morbidity between the two groups were not statistically significant，（χ2=1.409，P>0.05；χ2=1.053，P>0.05）， besides， the differences in the improvement levels of PaO2，PaCO2， oxygen saturation of blood and serum CysC between the two groups were statistically significant （t=12.604，P<0.05；t=14.218，P<0.05；t=9.637，P<0.05；t=6.843，P<0.05）. Conclusion The application of noninvasive ventilation combined with naloxone in patients with AECOPD and respiration failure can obviously improve the treatment effective rate， shorten the length of stay， and improve the clinical symptoms compared with the simple noninvasive ventilation， which is conductive to the prognosis of patients.

[Key words] COPD； Respiration failure； Noninvasive ventilation； Naloxone

慢性阻塞性肺疾病COPD（Chronic Obstructive Pulmonary Disease）是一种肺部常见的慢性疾病，临床以气流不可逆性受限，且呈进行性发展为特征，该疾病发生发展与周围环境以及有害气体、颗粒引起的肺部异常炎症反应密切相关[1]。据估计，到2020年，COPD所导致的的患者死亡率将位居世界第3位。慢性阻塞性肺疾病急性加重期AECOPD（Acute Exacerbation of Chronic Obstructive Pulmonary Disease）患者常伴有呼吸衰竭，且患者在住院期间预后往往不良，因此早期对AECOPD伴呼吸衰竭患者进行治疗和干预至关重要[2]。该研究随机选取了2015年1月—2017年1月期间于该院急诊科门诊进行就诊并收治入院的伴有呼吸衰竭的80例AECOPD患者为研究对象，探讨了无创呼吸机联合纳洛酮的临床治疗疗效，现报道如下。