参麦注射液对无创通气治疗慢性阻塞性肺病并严重呼吸衰竭的影响

目的观察参麦注射液对接受无创正压通气治疗慢性阻塞性肺病（COPD）并严重呼吸衰竭患者的影响.方法对照组（23例）在给予常规治疗的同时无创通气,治疗组（25例）在常规治疗无创通气的基础上加用参麦注射液30ml静脉点滴,每天1次,共10天;对所有患者进行血氧饱和度等监测,分别于治疗前,治疗后6h、24h、3d、7d行动脉血分析,并观察记录神志、呼吸、心率、呼吸困难等在各个治疗时期的变化.结果治疗组患者均明显好转出院,对照组治疗后3例无改善而改用有创通气治疗,其余20例患者均好转出院;住院时间：治疗组为（11.3±2.5）d,对照组为（13.2±2.7）d;机械通气时间：治疗组为（5.8±2.8）d,对照组为（7.5±3.0）d;上述指标两组比较差异均有显著性（P＜0.05）.3d、7d时呼吸困难计分组间比较差异有显著性（P＜0.05,P＜0.01）;动脉血气分析结果治疗组明显优于对照组（P＜0.05）;面部压伤、感染等不良反应治疗组明显减少.结论参麦注射液对无创通气治疗COPD并严重呼吸衰竭能明显缩短患者住院和机械通气时间,不良反应发生率明显下降.

Effects of Shenmai Injection on the Clinical Efficacy of Non invasive Ventilation in Patients with Severe Respiratory Failure Caused by Chronic Obstructive Pulmonary Disease

OBJECTIVE: To study the effect of Shenmai Injection (SMI) on the clinical efficacy of noninvasive positive-pressure ventilation (NPPV) in treating patients with severe respiratory failure (RF) caused by chronic obstructive pulmonary disease (COPD). METHODS: Patients in the control group (n=23) were treated with conventional therapy plus NPPV, and those in the treatment group (n=25) received the same treatment but with intravenous infusion of SMI 30 ml once a day additionally. The treatment lasted for 10 days. Arterial oxygen saturation (SaO2) was continuously monitored in all patients, arterial blood gas values was determined before treatment and at the 6th hour, the 24th hour, the 3rd day and the 7th day after treatment, and consciousness, breath, heart rate and severity of dyspnea were observed during the treating period. RESULTS: All patients in the treatment group were markedly improved and discharged from hospital, while in the control group 20 were improved and discharged from hospital, but the other 3 failed to be remitted and received the conventional invasive mechanical ventilation. The duration of hospitalization and ventilation were 11.3 +/- 2.5 d and 5.8 +/- 2.8 d in the treatment group, and 13.2 +/- 2.7 d and 7.5 +/- 3.0 d in the control group, showing significant difference in the two indexes between the two groups (P < 0.05). The dyspnea score and the arterial blood gas values determined on the 3rd and 7th day were significantly improved in the treatment group than those in the control group (P < 0.05 or P < 0.01). The incidence of endotracheal intubation caused adverse reaction, such as facial-skin crush wound, abdominal distention and contaminated infection in the treatment group was obviously lessened as compared with the control group. CONCLUSION: SMI could shorten the duration of hospitalization and mechanical ventilation, reduce trachea cannulation, and decrease the incidence of complications and adverse reactions in the patients with severe RF due to COPD treated with NPPV.