摘要
目的 探讨无创正压通气(NPPV)联合纳洛酮治疗慢性阻塞性肺疾病急性加重期(AECOPD)并发呼吸衰竭患者的临床疗效。方法 回顾性选取2017年1月—2022年4月福建医科大学附属闽东医院收治的70例AECOPD并发呼吸衰竭患者作为研究对象,根据不同的治疗方式分为对照组33例和观察组37例。患者均接受常规治疗,在此基础上,对照组患者接受无创正压通气(NPPV)治疗,观察组在对照组基础上加用盐酸纳洛酮注射液治疗。2组均治疗1周。比较2组治疗前及治疗1周后生命体征指标[脉搏、收缩压(SBP)、舒张压(DBP)、呼吸频率]、血气分析指标[血氧饱和度(SpO_(2))、动脉血二氧化碳分压(Pa CO_(2))、动脉血氧分压(PaO_(2))]、肺功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及呼气峰值流速(PEF)]、生活质量评分及不良反应发生率。结果 治疗1周后,2组脉搏、SBP、DBP、呼吸频率及Pa CO_(2)均较治疗前降低,SpO_(2)、PaO_(2)均较治疗前升高,且观察组Pa CO_(2)均较对照组更低,SpO_(2)、PaO_(2)较对照组更高(P<0.01)。治疗1周后,2组FEV_(1)、FVC、PEF及躯体、认知、情绪、角色、社会功能、总体健康评分均较治疗前升高,且观察组较对照组更高(P<0.01)。治疗期间,观察组不良反应总发生率为8.11%,与对照组的15.15%比较,差异无统计学意义(χ^(2)=0.855,P=0.462)。结论 NPPV联合纳洛酮治疗AECOPD并发呼吸衰竭可更有效地改善患者血气及肺功能,提高生活质量,且安全性较高。
Objective To discuss the clinical effect of NPPV combined with naloxone for AECOPD complicated with respiratory failure. Methods A total of 70 cases of AECOPD patients complicated with respiratory failure were selected from January 2017 to April 2022 in Mindong Hospital Affiliated to Fujian Medical University, and they were divided into the control group for 33 cases and the observation group for 37 cases. Patients were given conventional therapy, on the basis of this, patients in the control group were treated with NPPV, patients in the observation group were given naloxone hydrochloride injection on the basis of the control group. Both groups were treated with 1 week. Vital signs indexes(pulse, SBP, DBP, respiratory rate), blood gas analysis indexes(SpO_(2), Pa CO_(2), PaO_(2)), lung function indexes(FEV_(1), FVC, PEF) and quality of life score before and after 1 week of treatment, and incidence of adverse reactions were compared between the two groups. Results At 1 week of treatment, pulse, SBP, DBP, respiratory rate and Pa CO_(2)in the two groups were lower than those before treatment, SpO_(2), PaO_(2)were higher than those before treatment, and Pa CO_(2)in the observation group was lower than that in the control group, SpO_(2), PaO_(2)were higher than those in the control group(P<0.01). At 1 week of treatment, FEV_(1), FVC, PEF and score of body, cognition, emotion, role, social function, general health in the two groups were higher than those before treatment, and those in the observation group were higher than control group(P<0.01). There was no significant difference of incidence of adverse reactions between the observation group(8.11%) and the control group(15.15%) during treatment(χ^(2)=0.855, P=0.462). Conclusion NPPV combined with naloxone can more effectively improve the blood gas analysis and lung function for AECOPD patients complicated with respiratory failure, promote quality of life, and with high safety.
作者
黄兴伟
叶开颂
杨瑞党
HUANG Xingwei;YE Kaisong;YANG Ruidang(Department of Emergency,Mindong Hospital Affiliated to Fujian Medical University,Fuan 355000,China)
出处
《临床合理用药杂志》
2023年第3期1-4,共4页
Chinese Journal of Clinical Rational Drug Use
关键词
慢性阻塞性肺疾病
急性加重期
呼吸衰竭
无创正压通气
纳洛酮
血气分析
肺功能
Chronic obstructive pulmonary disease
Acute exacerbation period
Respiratory failure
Noninvasive positive pressure ventilation
Naloxone
Blood gas analysis
Lung function
