BiPAP机间歇通气联合纳络酮治疗慢性阻塞性肺疾病急性加重伴呼吸衰竭效果分析.docVIP

BiPAP机间歇通气联合纳络酮治疗慢性阻塞性肺疾病急性加重伴呼吸衰竭效果分析 　　[摘要]目的 探?采用BiPAP机间歇通气联合纳络酮治疗慢性阻塞性肺疾病急性加重期（AECOPD）伴呼吸衰竭的效果。方法 选取2012年1月～2014年12月于本院住院治疗的46例AECOPD伴呼吸衰竭患者作为研究对象，随机分为BiPAP机通气组与对照组，各23例。对照组常规给予氧疗、抗感染、解痉、对症治疗，必要时行机械通气治疗。BiPAP机通气组在常规给予氧疗、抗感染、解痉、对症治疗的基础上，采用BiPAP无创呼吸机间歇通气联合纳络酮进行治疗。观察两组治疗前后的动脉血气分析变化和6 min步行距离变化。结果 两组治疗后的PaO2水平高于治疗前，PaCO2水平低于治疗前，差异有统计学意义（P0.05）。BiPAP机通气组治疗后的PaO2水平高于对照组，PaCO2水平低于对照组，差异有统计学意义（P0.05）。两组治疗后的6 min步行距离长于治疗前，差异有统计学意义（P0.05）。BiPAP机通气组治疗后的6 min步行距离长于对照组，差异有统计学意义（P0.05）。BiPAP机通气组均不需要行气管插管和机械通气治疗。结论 BiPAP机间歇通气联合纳络酮治疗AECOPD呼吸衰竭患者有较好的效果，且无明显不良反应发生。 　　[关键词]间歇通气；纳络酮；慢性阻塞性肺疾病急性加重期；6 min步行距离 　　[中图分类号] R563.9 [文献标识码] A [文章编号] 1674-4721（2017）02（b）-0031-03 　　[Abstract]Objective To investigate the effect of BiPAP intermittent ventilation combined with Naloxone in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） complicated with respiratory failure.Methods 46 patients with AECOPD complicated with respiratory failure who were hospitalized in our hospital from January 2012 to December 2014 were selected and randomly divided into the BiPAP ventilation group and the control group，23 cases in each group.The control group was given conventional oxygen therapy，anti-infection，antispasmodic，and symptomatic treatment，if necessary，the control group was given mechanical ventilation treatment.The BiPAP ventilation group was treated with intermittent ventilation by BiPAP non-invasive ventilator combined with Naloxone on the basis of the conventional oxygen therapy，anti-infection，antispasmodic，and symptomatic treatment.Changes in arterial blood gas analysis and changes in 6-minute walking distance before and after treatment were observed between the two groups.Results The level of PaO2 in the two groups after treatment was higher than that before treatment，and the level of PaCO2 in the two groups after treatment was lower than that before treatment，with significant difference （P 　　[Key words]Intermittent ventilation；Naloxone；Acute exacerbation