纳洛酮联合无创通气治疗COPD并发肺脑的疗效分析

目的 评价纳洛酮与无创机械通气联合治疗并发肺性脑病的慢性阻塞性肺疾病临床疗效及其安全性.方法 将我院ICU收治的84名COPD并发肺性脑病的患者随机分为对照组和实验组,对照组采用临床常规治疗和无创通气治疗,实验组在对照组的基础上应用纳洛酮,观察并对比两组患者的临床治疗效果,记录意识恢复时间、气管插管率,并进行动脉血气分析.结果 实验组治疗有效率（88.10%）高于对照组（64.29%）,气管插管率和平均意识恢复时间均明显低于对照组,实验组治疗24 h后动脉血气分析指标改善程度优于对照组,P＜0.05,有统计学意义.结论 纳洛酮联合无创通气治疗COPD并发肺性脑病临床疗效好,安全性高.

Analysis of clinical effect and safety of naloxone combined with noninvasive mechanical ventilation in the treatment of patients with pulmonary encephalopathy complicated with chronic obstructive pulmonary disease

Objective To evaluate the clinical effect and safety of naloxone plus noninvasive mechanical ventilation in the treatment of patients with chronic obstructive pulmonary disease （COPD） complicated with pulmonary encephalopathy. Methods 84 COPD patients complicated with pulmonary encephalopathy were randomly divided into the experiment group and the control group. The control group was treated with clinical routine therapy and noninvasive ventilation, and the experiment group was additionally treated with naloxone on the basic of the control group. The clinical effect was observed and compared between the two groups. Results The effective rate was 88. 10% in the experiment group and 64.29% in the control group respectively, with significant difference. The rate of endotracheal intubation and the average consciousness recovery time were obviously lower in the experiment group than in the control group. The improvement of blood gas analysis indexes 24 hours after the treatment was more pronounced in the experiment group than in the control group （ P 〈 0. 05 ）. Conclusion Naloxone combined with noninvasive mechanical ventilation has good clinical curative effect and high safety in the treatment of COPD patients complicated with pulmonary encephalopathy.