纳洛酮与无创呼吸机联合在老年慢性阻塞性肺疾病并发呼吸衰竭治疗中的应用分析

目的 观察纳洛酮联合无创呼吸机治疗老年慢性阻塞性肺疾病并发呼吸衰竭的临床疗效.方法 选取老年慢性肺心病并发呼吸衰竭患者78例,随机分为观察组和对照组各39例.两组患者均给予基础治疗方案进行治疗,对照组加用无创呼吸机进行治疗,观察组在对照组的基础上,予静脉应用纳洛酮进行治疗.治疗1周后,对比两组患者的临床疗效和血气分析指标的改善情况.结果 经过治疗后,观察组显效率为46.15％,总有效率为94.87％,均显著高于对照组的23.08％和74.36％ （P＜0.05）.观察组治疗后的血氧分压为（86.72±8.34）mmHg,血二氧化碳分压为（41.01±3.72）mmHg,酸碱值为（7.37±0.19）;对照组的血氧分压为（74.23±7.38） mmHg,血二氧化碳分压为（48.22±6.27）mmHg,酸碱值为（7.31±0.12）,两组患者治疗后的血氧分压、酸碱值均显著高于治疗前,而血二氧化碳分压显著低于治疗前（均P＜0.05）.观察组治疗后的血氧分压、酸碱值均显著高于对照组,而血二氧化碳分压显著低于对照组（均P＜0.05）.结论 纳洛酮与无创呼吸机的联合使用可提高老年慢性阻塞性肺疾病并发呼吸衰竭的临床治疗效果,并迅速改善患者低氧血症和二氧化碳潴留状态,值得在临床上进一步推广应用.

Application of naloxone combined with non invasive ventilation in treatment of elderly patients with chronic obstructive pulmonary disease complicated with respiratory failure

Objective To observe the clinical efficacy of naloxone combined with non invasive ventilation in the treatment of elderly patients with chronic obstructive pulmonary disease complicated with respiratory failure, in order to improve the clinical effect of this disease. Methods 78 elderly patients with chronic pulmonary heart disease complicated with respiratory failure were randomly divided into observation group and control group with 39 cases in each. Two groups of patients were given treatment of foundation treatment, while in the control group were treated with non-inva- sire ventilation treatment, the observation group by intravenous naloxone treatment. After 1 week of treatment, the clin- ical effect and blood gas analysis index were compared. Results After treatment, the effective rate was 46. 15~, the to- tal effective rate was 94. 870/6o in the observation group, significantly higher than that of control group （23.08o/60, 74. 360//oo）. The partial pressure of oxygen was （86.72~8.34） mmHg, blood carbon dioxide pressure was （41.01~3.72） mmHg, pH value was （7.37＋0.19）; the partial pressure of oxygen and pH were significantly higher than that before treatment, and the partial pressure of carbon dioxide was significantly lower than that before treatment （P〈0.05）. The partial pressure of oxygen and pH value in the observation were significantly higher than those in control group, and par- tial pressure of carbon dioxide was significantly lower than those of control group （P〈0. 05）. Conclusion Naloxone combined with non invasive ventilation can improve the clinical effect of the treatment of elderly patients with chronic ob- structive pulmonary disease complicated with respiratory failure. It can rapidly improve hypoxemia and hypercapnia state, worthy of further application in clinical practice.