无创正压通气联合纳洛酮治疗慢性阻塞性肺疾病合并肺性脑病早期临床研究.docVIP

精品论文 参考文献 无创正压通气联合纳洛酮治疗慢性阻塞性肺疾病合并肺性脑病早期临床研究 中国人民解放军第一五三中心医院呼吸内科 郑州 450042 【摘 要】目的：观察无创正压通气联合纳洛酮在慢性阻塞性肺疾病（COPD）合并肺性脑病早期治疗中的临床效果。方法：入选我院近2年符合COPD合并肺性脑病诊断患者98例，随机分为对照组（C组）50例及纳洛酮组（N组）48例，所有患者均给予抗感染、解痉平喘、营养支持等内科常规治疗+无创正压通气，N组患者另给予纳洛酮治疗，若两组患者病情恶化，立即给予气管插管机械通气。观察并记录两组患者治疗前及辅助通气后24h、72h的血气（PCO2、PaO2、pH值）变化及治疗结束后两组患者的平均住院日、平均无创正压通气时间及气管插管率。结果：两组患者治疗后动脉血气PCO2、PaO2、pH值较治疗前均有明显改善（Plt;0.05），且N组患者治疗后24h、72h动脉???气PCO2、PaO2值较同期C组改善更显著（Plt;0.05）；N组住院时间、无创正压通气时间、气管插管率较C组明显降低（Plt;0.05）。结论：COPD合并肺性脑病早期给予无创正压通气联合纳洛酮治疗较单纯无创正压通气疗效更好。 【关键词】无创正压通气；纳洛酮；慢性阻塞性肺疾病；肺性脑病 Noninvasive positive pressure ventilation combined with naloxone clinical efficacy of reatment of chronic obstructive pulmonary disease with pulmonary encephalopathy Yehejiang（Department of Respiratory Medicine，The Peoples Liberation Army first fifty-three Central Hospital，Zhengzhou 450042，China） 【Abstract】Objective：Noninvasive positive pressure ventilation combined with naloxone clinical effect in patients with chronic obstructive pulmonary disease（COPD）Pulmonary Encephalopathy early therapy.Methods：Selected hospital nearly two years in line with the combined COPD patients with the diagnosis of 98 cases of pulmonary encephalopathy were randomly divided into control group（group C）50 examples and naloxone group（N group）48 cases，all patients were given antibiotics，antispasmodic flat asthma，nutritional support and other conventional medical therapy plus noninvasive positive pressure ventilation，N group were given another naloxone treatment，if patients were disease progression，immediate intubation and mechanical ventilation.Observe and record the blood（PCO2，PaO2，pH value）changes in two groups of patients and hospital stay after the end of treatment，noninvasive positive pressure ventilation and intubation rate 24h，72h of the two groups of patients before and after treatment and assisted ventilation.Results：The two groups of patients after treatment before arterial blood gas（PCO2，PaO2，pH values）were significantly improved compare