国产纳洛酮治疗肺心病急性发作期所致肺性脑病40例临床疗效观察

为观察国产纳洛酮对COPD所致肺心病急性发作期合并肺性脑病的临床疗效。选择我院内科自1995年2月～1998年12月80例肺心病急性发作期合并肺性脑病患者,分成两组:应用纳洛酮组为试验组(A组),未用纳洛酮组为对照组(B组),每组各40例,两组现察时限均以24小时为标准。A组应用国产纳洛酮0.4mg,静脉注入,每小时1次,至病人意识障碍消失恢复清醒,观察用药前后的意识状态,血压、脉搏、呼吸、心率、动脉血气分析的变化。A组用药后24小时内有34例意识障碍消失(75％),而B组有12例意识障碍消失(25％),二者相比有显著性差异(P<0.05)。A组用药后的多数病例在8小时至16小时之内意识障碍得以恢复,呼吸、心率有显著意义的下降(P<0.05),呼吸频率下降10～13次/分,心率下降15～30次/分。血压无显著意义变化。PaCO_2与用药前相比,有显著意义的下降(P<0.05)、下降2～4kPa。pHa,PaO_2,SaO_2与用药前相比均有显著意义的升高(P<0.05),pHa升高幅度0.21～0.27,PaO_2升高1.5～2.21kPa,SaO_2升高9～12％。A组RR、HR、PaCO_2明显低于B组(P<0.05),pHa,PaO_2,SaO_2明显高于对照组。观察结果显示国产纳洛酮对肺心病急性发作期合并的肺性脑病,具有一定的治疗作用,从而为肺心病急性发作期合并肺性脑病的治疗提供了一种方法。

The Therapeutical Effects of Naloxone on Chronic Obstractive Pulmonary Disease Induced Carbon Dioxide Anesthesia-A 40 Cases Report

To estimate The therapeutical effects of Naloxone on chronicobstructive Pulmonary disease induced carbon dioxide anesthesia -A 40 cases report,The 80 patients with chronic obstructive pulmonary disease induced carbon dioxide anesthesia from February 1995 to December 1998 were chosen to bedivided into two groups,First is 40 cases(named group A)to be iv 0. 4mg qlh tillthe patients recover from the conscious disturbance in 24 hours,The consciousnesswere observed,respiratory rate、blood pressure、heart rate and arterial gas-analysis of the patients were measured before and after the drug administration,34 cases in group A recover from the conscious disturbance(85%) ,12 cases in groupB recover from the conscious disturbance(30%),There is significantly difference in two groups,In group A. There is no significant changes in blood pressure,Respiratory rate and heart rate significantly decrease after the drug administration( P <0. 05),pHa ,PaO2 and SaO2 were significantly increased after the drug administration. The extent increased were from 0. 21 to 0. 27, 1. 5 kPa to 2. 21kPa,9% to 12%,respectively( P <0. 05,PaCO2 significantly decreasedl the degrees of drops were from 2kPa to 4kPa( P <0. 05). Respiratory rate,Heart rate and PaCO2 in group A significantly decrease( P <0. 05) ,pHa, PaO2 and SaO2 Signficantly increase respectively ( P <0. 05). Our study shows that Naloxone has definitively therapeutical effects on the Patients with chronic obstructive pulmonary disease induced carbon dioxide anesthesi-a. Our study also offers a therapeutical method for the patients with chronic obstructive pulmonary disease induced carbon dioxide anesthesia.