无创呼吸机联合纳洛酮治疗慢性阻塞性肺病合并呼吸衰竭的临床效果

目的探讨无创呼吸机联合纳洛酮治疗慢性阻塞性肺病(COPD)合并呼吸衰竭的临床效果。方法选取2015年1月至2018年1月我院收治的92例COPD合并呼吸衰竭患者为研究对象,按照不同治疗方式将其分为对照组(46例,常规治疗+无创呼吸机)与观察组(46例,常规治疗+无创呼吸机+纳洛酮)。比较两组患者的临床疗效、血气指标、呼吸力学指标、炎症因子水平及呼吸困难程度。结果治疗后,观察组患者的治疗总有效率高于对照组(P<0.05);治疗后,两组患者的PaCO2、OI、RI均降低,PaO2均升高,且观察组优于对照组(P<0.05);两组患者的pH比较,差异无统计学意义(P>0.05);治疗后,两组患者的PIP、Pm和PP均升高,Cdyn、Raw、IL-8、TNF-α水平、呼吸困难程度评分均降低,且观察组优于对照组,差异具有统计学意义(P<0.05)。结论无创呼吸机联合纳洛酮治疗COPD合并呼吸衰竭患者的效果显著,可以改善患者的血气指标和呼吸力学指标,恢复肺通气功能,减轻炎症反应,值得临床推广应用。

Clinical effect of non-invasive ventilator combined with naloxone in the treatment of chronic obstructive pulmonary disease complicated with respiratory failure

Objective To investigate the clinical effect of non-invasive ventilator combined with naloxone in the treatment of chronic obstructive pulmonary disease(COPD) combined with respiratory failure. Methods A total of 92 patients with COPD combined with respiratory failure admitted in our hospital from January 2015 to January 2018 were selected as study objects. The patients were divided into control group(46 cases, routine treatment+non-invasive ventilator)and observation group(46 cases, routine treatment +non-invasive ventilator +naloxone) according to different treatment methods. The clinical treatment efficacy, blood gas indexes, respiratory mechanics indexes, levels of inflammation factors and dyspnea degree of the two groups were compared. Results After treatment, the total effective rate of treatment in the observation group was higher than that in the control group(P<0.05);after treatment, PaCO2, OI and RI in the two groups decreased, PaO2 increased, and those in the observation group were superior to the control group(P<0.05);there was no statistically significant difference in p H between the two groups(P >0.05);after treatment, the PIP, Pm and PP in both groups increased, Cdyn, Raw, the levels of IL-8 and TNF-α, the scores of dyspnea degree decreased, and those in the observation group were superior to the control group(P<0.05). Conclusion Non-invasive ventilator combined with naloxone in the treatment of patients with COPD combined with respiratory failure is effective. It can improve the blood gas indexes and respiratory mechanics indexes of patients, restore lung ventilation function and reduce inflammatory reaction, which is worth clinical promotion and application.