摘要
目的探讨全身应用甲强龙联合呼吸兴奋剂尼可刹米对慢性阻塞性肺病急性加重期患者治疗效果的影响。方法75例慢性阻塞性肺病急性加重期合并Ⅱ型呼吸衰竭不能耐受无创呼吸机辅助通气患者,给予常规治疗和呼吸兴奋剂基础上,根据应用糖皮质激素甲强龙的剂量随机平分成3组,观察动脉血气参数PH值、氧分压(PaO2)、二氧化碳分压(PaCO2)的变化。结果呼吸兴奋剂联合不同剂量的糖皮质激素甲强龙能够显著纠正患者的PH值即酸中毒,提高氧分压,降低二氧化碳分压。选择应用甲强龙40 mg每12小时1次可能更优于其他剂量。结论慢性阻塞性肺病急性加重期合并Ⅱ型呼吸衰竭不能耐受无创呼吸机辅助通气患者,应用呼吸兴奋剂尼可刹米基础上应用糖皮质激素是有效而安全的治疗方法;糖皮质激素选择合适的剂量对达到最佳的治疗效果非常重要。
Objective To investigate the effect of systemic glucocorticoid methylprednisolone combined with respiratory stimulant nikethamide in the treatment of patients with AECOPD. Methods 75 AECOPD patients complicated with type lI respiratory failure, who could not tolerate BiPAP ventilator, were given regular treatment and respiratory stimulant nikethamide. Then they were evenly divided into three groups according to the doses of glucocorticoid methylprednisolone. The indexes of arterial blood gas analysis was compared among the three groups. Results Respiratory stimulant nikethamide combined with different dose of glucocorticoid methylprednisolone could sig- nificantly improve the value of PH, increase partial pressure of oxygen and decrease partial pressure of carbon dioxide. The dose of 40rag of methylprednisolone every 12 hours had the best curative effect. Conclusion Glucocorticoid combined with respiratory stimulant niketh- amide is safe and effective in the treatment of AECOPD patients complicated with type II respiratory failure, who can not tolerate BiPAP ventilator. The dose of glucocorticoid methylprednisolone is very important for the treatment.
出处
《临床肺科杂志》
2013年第10期1749-1750,共2页
Journal of Clinical Pulmonary Medicine
基金
国家自然科学基金青年培育计划(No 2010KJ14)
关键词
糖皮质激素
呼吸兴奋剂
慢性阻塞性肺病
急性加重期
glucocorticoid
respiratory stimulant
chronic obstructive pulmonary disease
acute exacerbation
