纳洛酮降阶梯治疗肺性脑病87例疗效评价

目的观察纳洛酮降阶梯治疗AECOPD并发Ⅱ型呼吸衰竭肺性脑病的临床疗效。方法将87例病例随机分为治疗组及对照组,两组均予积极控制感染,持续低流量吸氧,解痉平喘,止咳化痰,营养支持等综合治疗。治疗组在此基础上加用纳洛酮注射剂,首剂负荷量2 mg静脉推注,以后每隔2 h减0.4 mg纳洛酮静脉注射,4 h后纳洛酮0.8 mg静脉注射q2h,24 h纳洛酮总剂量为12 mg;对照组纳洛酮4 mg兑入0.9%NS中24 h持续泵入,连用3 d。结果治疗组总有效率90.6%,对照组总有效率为67.4%,治疗组显著高于对照组（P〈0.01）;动脉血气分析指标：对照组和治疗组治疗后动脉血气分析值比较P〈0.05,治疗组和对照组治疗前动脉血气分析值比较P〉0.05,治疗组治疗前后动脉血气分析值比较P〈0.001;结论纳洛酮降阶梯治疗AECOPD合并呼吸衰竭肺性脑病临床疗效确切。

Naloxone treatment of pulmonary encephalopathy escalation Clinical evaluation of 87 cases

Objective To observe the escalation of naloxone treatment of AECOPD patients with type Ⅱ respiratory failure,the clinical efficacy of pulmonary encephalopathy.Methods 87 cases were randomly divided into treatment group and control group are to be active to control infection,continuous low flow oxygen,antispasmodic asthma,refreshment,and nutrition support of patients.The treatment group was based on the use of naloxone injection,the first loading dose 2 mg intravenous injection,every two hours later by 0.4 mg intravenous naloxone,4 hours after intravenous injection of naloxone 0.8 mg q2h,24 h total dose of naloxone 12 mg;control group naloxone 4 mg Duiru 0.9% NS for 24 hours continuous infusion once a 3 d.Results The total effective rate was 90.6%,control group 67.4% of the total effective rate in treatment group was significantly higher（P0.01）;arterial blood gas analysis：the control group and treatment group,compared arterial blood gas analysis values P0.05,treatment group and control group before treatment values of arterial blood gas analysis comparison P0.05,treatment group,arterial blood gas analysis values before and after treatment comparison P0.001;Conclusion Naloxone treatment of AECOPD escalation with respiratory failure the exact effect of pulmonary encephalopathy.