BiPAP通气联合纳洛酮在Ⅱ型呼吸衰竭合并肺性脑病治疗中的疗效分析

目的:探讨BiPAP通气联合纳洛酮在Ⅱ型呼吸衰竭合并肺性脑病治疗中的疗效。方法:选择我院内一科2007年1月～2010年12月收治的Ⅱ型呼吸衰竭合并肺性脑病患者82例,分为治疗组和对照组组各41例。两组均予一般治疗,治疗组在此基础上使用BIPAP呼吸模式呼吸机联合纳洛酮辅助治疗,对照组单纯BiPAP通气,不予纳洛酮治疗。结果:两组治疗后血气分析结果均较治疗前有显著好转,有统计学差异,P<0.05。单治疗组治疗后较对照组治疗后变化更为显著,有统计学差异,P<0.05。对照组死亡率和治疗无效率分别为5.3%（2/41）和11.2%（5/41）,治疗组死亡率和治疗无效率分别为0（0/41）和7.3%（3/41）,两组差异有显著性（P<0.05）;两组动脉血及上腔静脉血氧分压差（△PO₂）比较,二者差异无显著性（P>0.05）。结论:当患者PaCO2显著增高或伴轻型肺性脑病时,纳洛酮联合BiPAP通气治疗可显著减轻二氧化碳潴留,较单用BiPAP通气更有效地降低气管插管或气管切开率。

The Effect of BiPAP Union Naloxone in Treatment of Type Respiratory Failure Complicated with Pulmonary Encephalopathy

Objective:To explore the therapeutic effect of noninvasiv epositive ventilation plus Naloxone in treatment of type respiratory failure complicated with pulmonary encephalopathy.Methods:82 patients were randomly divided into 2 groups.All cases received conventional medical therapy,control group 41 cases received noninvasiv epositive ventilation,and treatment group received noninvasiv epositive ventilation puls Naloxone.Clinical manifestations and changes of arterial blood gas were observed before and after treatment.Results:After two groups treat,before the courage vigor analysis result treats,has the remarkable change for the better,has statistics difference.After the list treatment group treats,after calling the control group treats,to change is more remarkable,has statistics difference.The control group mortality rate and the treatment inefficiency respectively are 5.3%(2/41),11.2%(5/41),the treatment group mortality rate and the treatment inefficiency respectively are 0%(0/41),7.3%(3/41),two groups of differences have the significance.Two group of artery blood and the epicoele venous blood oxygen partial pressure difference comparison,the two difference does not have the significance.Conclusion:Combined use of no ninvasive ventilation puls Nalox one can rapidly improve clinical symptoms and arterial blood gases.