纤维支气管镜联合纳洛酮治疗老年重症呼吸衰竭患者的疗效观察

目的 探讨纤维支气管镜联合纳洛酮治疗老年重症呼吸衰竭患者的临床应用效果及对患者血气情况与肺功能的改善作用。方法 选取2016年5月—2018年4月就诊于辽油宝石花医院的老年慢性阻塞性肺病（chronic obstructive pulmonary disease，COPD）伴重症呼吸衰竭患者共69例作为研究对象，采用随机数表法将其分为试验组和对照组，对照组予以常规气管插管机械通气治疗，试验组则采用纤维支气管镜联合纳洛酮治疗，比较2组治疗效果及不同治疗方法对患者血气指标和肺功能改善情况。结果 治疗前，2组患者肺功能指标和胸肺顺应性指标测定结果无明显差异，治疗后2组肺功能指标和胸肺顺应性指标测定结果较治疗前均明显改善，且试验组改善情况明显优于对照组（P<0.05）。治疗后血气相关指标测定结果显示，试验组呼吸频率和p（CO₂）水平明显低于对照组（P<0.05），pH水平比较无明显差异，SaO₂和p（O₂）水平明显高于对照组（P<0.05）；试验组总体住院时间明显短于对照组（P<0.05），死亡率及并发症发生率明显低于对照组（P<0.05）。结论 纤维支气管镜联合纳洛酮治疗老年重症呼吸衰竭疗效显著，能快速改善患者肺通气功能和血气指标，降低肺部感染风险，安全性高，值得推广应用。

Therapeutic Effect of Fiberoptic Bronchoscopy Combined with Naloxone on Elderly Patients with Severe Respiratory Failure

OBJECTIVE To investigate the clinical effect of fiberoptic bronchoscopy combined with naloxone in the treatment of elderly patients with severe respiratory failure and the improvement of blood gas and pulmonary function. METHODS Sixty-nine elderly patients with chronic obstructive pulmonary disease(COPD) accompanied by severe respiratory failure who were treated in Liaoyou Baoshihua Hospital from May 2016 to April 2018 were selected as the study subjects. They were divided into experimental group and control group by random number table method. The control group was treated with conventional tracheal intubation mechanical ventilation, and the experimental group was treated with fiberoptic bronchoscopy combined with naloxone. The therapeutic effects of the two groups and the improvement of blood gas parameters and lung function were compared between the two groups. RESULTS Before treatment, there was no significant difference in the results of pulmonary function index and thoracic and pulmonary compliance index between the two groups. After treatment, the results of pulmonary function index and thoracic and pulmonary compliance index of the two groups were significantly improved, and the improvement of the experimental group was significantly better than that of the control group(P<0.05). The results of blood gas related indicators after treatment showed that the respiratory rate and p(CO₂) level in the experimental group were significantly lower than those in the control group(P<0.05); there was no significant difference in pH level; SaO₂ and p(O₂) levels were significantly higher than the control group(P<0.05). The overall hospitalization time of the experimental group was significantly shorter than that of the control group(P<0.05); the mortality and complication rate were significantly lower than the control group(P<0.05). CONCLUSION Fiberoptic bronchoscopy combined with naloxone is effective in the treatment of elderly patients with severe respiratory failure. It can rapidly improve the lung ventilation function and blood gas index, reduce the risk of lung infection, and has high safety. It is worthy of popularization and application.