鼻面罩无创正压通气联用呼吸兴奋剂治疗慢阻肺呼吸衰竭合并肺性脑病患者的疗效

目的：评价鼻面罩无创正压通气联用呼吸兴奋剂治疗慢阻肺呼吸衰竭合并肺性脑病患者的疗效。方法将68例慢阻肺呼吸竭合并肺性脑病患者随机分为对照组和观察组，分别给予鼻面罩无创正压通气治疗和鼻面罩无创正压通气联用呼吸兴奋剂治疗，评价联合治疗方法的临床疗效。结果两组患者通气3h 后和治疗结束时的 pH、PaO2和 PaCO2较治疗前均明显好转，观察组患者的恢复情况优于对照组（P ＜0.05）。经过治疗后，观察组患者通气有效率85.29%，明显高于对照组（P ＜0.05），气管插管率和胃胀气发生率分别为14.71%和32.35%，低于对照组（P＜0.05），两组患者的住院病死率均为2.94%，差异无统计学意义（P＞0.05）。结论鼻面罩无创正压通气联用呼吸兴奋剂治疗慢阻肺呼吸竭合并肺性脑病的临床效果优于单纯鼻面罩无创正压通气，是一种较好的治疗方法。

A study on the curative efficacy of non-invasive positive pressure ventilation combined with respiratory stimulant in the treatment of COPD with respiratory failure in patients with pulmonary encephalopathy

Objective To evaluate the clinical effect of non-invasive positive pressure ventilation combined with respiratory stimulant in the treatment of COPD patients with respiratory failure and pulmonary encephalopathy. Methods 68 cases of COPD patients with respiratory failure and pulmonary encephalopathy were randomly divided into the observation group and the control group,which were treated with non-invasive positive pressure ventilation therapy and non-invasive positive pressure ventilation combined with respiratory stimulant respectively.Evaluation was given to the clinical curative effect of combined treatment method. Results the pH,PaO2 and PaO2 of patients in both group were significantly improved 3hours after and at the end of the treatment.And the recovery of the observation group was better than that of the control group（P 〈 0.05）.After treatment, ventilation efficiency of the patients in observation group was 85.29%,significantly higher than that in the observation group（P 〈 0.05）;The incidence of endotracheal intubation and bloating were respectively 14.71% and 32.35%,lower than those in the observation group （P 〈 0.05）;The mortality rates of the two groups of patients in hospital were both 2.94%,no significant difference（P 〉 0.05）. Conclusion The clinical effect of non-invasive positive pressure ventilation combined with respiratory stimulant in the treatment of COPD respiratory failure with pulmonary encephalopathy is better than that of the treatment method of sole non-invasive positive pressure ventilation;therefore it is a good treatment method.