摘要
目的 探讨老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并重症呼吸衰竭患者应用纤维支气管镜与纳洛酮联合方案实施治疗的效果及对呼吸功能的影响。方法 选取2022年1月—2023年1月巨野县人民医院收治的80例老年COPD合并重症呼吸衰竭患者作为研究对象,以随机数表法分为两组,每组40例。对照组应用常规气管插管机械通气方案实施治疗,观察组应用纤维支气管镜与纳洛酮联合方案展开治疗。对比两组总有效率、呼吸功能指标、血气指标、血清炎性指标、并发症发生率。结果 观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组潮气量、气道峰压比较,差异无统计学意义(P>0.05);治疗后,两组气道峰压均降低,潮气量均上升,且观察组优于对照组,差异有统计学意义(P<0.05)。治疗前两组动脉血二氧化碳分压、动脉氧分压比较,差异无统计学意义(P>0.05);治疗后,两组动脉血二氧化碳分压均降低,动脉氧分压均上升,且观察组优于对照组,差异有统计学意义(P<0.05)。治疗前,两组C-反应蛋白、降钙素原水平比较,差异无统计学意义(P>0.05);治疗后,两组C-反应蛋白、降钙素原水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组所涉患者无肺部感染并发症,对照组有4例(10.00%)肺部感染并发症,但两组对比,差异无统计学意义(χ^(2)=2.368,P>0.05)。结论 针对老年COPD合并重症呼吸衰竭患者,应用纤维支气管镜与纳洛酮联合方案实施治疗,可提高总有效率,增强呼吸功能,改善血气指标,降低炎性反应程度,防范并发症,应用价值显著。
Objective To investigate the effect of fiber bronchoscope combined with Naloxone on respiratory function in the elderly patients with chronic obstructive pulmonary disease(COPD)combined with severe respiratory failure.Methods A total of 80 elderly patients with COPD complicated with severe respiratory failure admitted to Juye County People's Hospital from January 2022 to January 2023 were selected as the research objects,and they were divided into two groups by random number table method,with 40 cases in each group.The control group was treated with conventional tracheal intubation mechanical ventilation,and the observation group was treated with fiberoptic bronchoscopy combined with Naloxone.The total effective rate,respiratory function index,blood gas index,serum inflammatory index and complication rate were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in tidal volume and air⁃way peak pressure between the two groups(P>0.05);after treatment,the peak airway pressure of the two groups decreased,and the tidal volume increased,and those in the observation group were better than the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in arterial carbon dioxide partial pressure and arterial partial pressure of oxygen between the two groups before treatment(P>0.05);after treatment,arterial carbon dioxide partial pressure decreased and arterial partial pressure of oxygen increased in both groups,and those in the observation group were better than the control group,the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the levels of C-reactive protein and procalcitonin between the two groups(P>0.05);after treatment,the levels of C-reactive protein and procalcitonin in the two g
作者
黄璐
HUANG Lu(Department of Respiratory and Critical Care MedicineⅠ,Juye County People's Hospital,Heze,Shandong Province,274900 China)
出处
《世界复合医学》
2023年第5期106-109,119,共5页
World Journal of Complex Medicine
