北方药学
北方藥學
북방약학
JOURNAL OF NORTH PHARMACY
2015年
6期
106-107
,共2页
张秀珍%黄景培%陈样过%何润文
張秀珍%黃景培%陳樣過%何潤文
장수진%황경배%진양과%하윤문
无创双水平气道正压通气%纳洛酮%慢性阻塞性肺病%肺性脑病
無創雙水平氣道正壓通氣%納洛酮%慢性阻塞性肺病%肺性腦病
무창쌍수평기도정압통기%납락동%만성조새성폐병%폐성뇌병
Noninvasive bi-level positive airway pressure ventilation%Chronic obstructive pulmonary disease%Naloxone%Pulmonary encephalopathy
目的：观察无创双水平气道正压（BiPAP）通气联合纳洛酮（NLX）在慢性阻塞性肺病（COPD）急性加重期合并肺性脑病治疗中的应用。方法：选取66例COPD急性加重期合并肺性脑病患者分为两组，对照组采用吸氧、抗感染、化痰平喘常规综合治疗，观察组在此基础上使用纳洛酮首次0.8mg静脉注射，随后予3μg/（kg·h）微量泵持续静脉泵入，并持续使用BiPAP通气，观察两组疗效。结果：两组治疗后心率、呼吸频率、血压均有显著改善（P<0.05）。对照组治疗3h后PaO2和SaO2增加（P<0.05），但pH值和PaCO2均无明显改变（P均>0.05），部分患者甚至加重；24h时PaO2维持在较高水平，pH值和PaCO2改善仍不明显。与对照组比较，观察组治疗后各项指标均恢复正常（P<0.05）。观察组诊治时间短、气管插管率降低、病死率明显下降，这些数据与对照组相比，差异均具有统计学意义（P<0.05）。结论：BiPAP通气联用NLX治疗COPD急性加重期合并肺性脑病的临床效果较好，插管率、病死率明显降低。
目的：觀察無創雙水平氣道正壓（BiPAP）通氣聯閤納洛酮（NLX）在慢性阻塞性肺病（COPD）急性加重期閤併肺性腦病治療中的應用。方法：選取66例COPD急性加重期閤併肺性腦病患者分為兩組，對照組採用吸氧、抗感染、化痰平喘常規綜閤治療，觀察組在此基礎上使用納洛酮首次0.8mg靜脈註射，隨後予3μg/（kg·h）微量泵持續靜脈泵入，併持續使用BiPAP通氣，觀察兩組療效。結果：兩組治療後心率、呼吸頻率、血壓均有顯著改善（P<0.05）。對照組治療3h後PaO2和SaO2增加（P<0.05），但pH值和PaCO2均無明顯改變（P均>0.05），部分患者甚至加重；24h時PaO2維持在較高水平，pH值和PaCO2改善仍不明顯。與對照組比較，觀察組治療後各項指標均恢複正常（P<0.05）。觀察組診治時間短、氣管插管率降低、病死率明顯下降，這些數據與對照組相比，差異均具有統計學意義（P<0.05）。結論：BiPAP通氣聯用NLX治療COPD急性加重期閤併肺性腦病的臨床效果較好，插管率、病死率明顯降低。
목적：관찰무창쌍수평기도정압（BiPAP）통기연합납락동（NLX）재만성조새성폐병（COPD）급성가중기합병폐성뇌병치료중적응용。방법：선취66례COPD급성가중기합병폐성뇌병환자분위량조，대조조채용흡양、항감염、화담평천상규종합치료，관찰조재차기출상사용납락동수차0.8mg정맥주사，수후여3μg/（kg·h）미량빙지속정맥빙입，병지속사용BiPAP통기，관찰량조료효。결과：량조치료후심솔、호흡빈솔、혈압균유현저개선（P<0.05）。대조조치료3h후PaO2화SaO2증가（P<0.05），단pH치화PaCO2균무명현개변（P균>0.05），부분환자심지가중；24h시PaO2유지재교고수평，pH치화PaCO2개선잉불명현。여대조조비교，관찰조치료후각항지표균회복정상（P<0.05）。관찰조진치시간단、기관삽관솔강저、병사솔명현하강，저사수거여대조조상비，차이균구유통계학의의（P<0.05）。결론：BiPAP통기련용NLX치료COPD급성가중기합병폐성뇌병적림상효과교호，삽관솔、병사솔명현강저。
Objective:To discuss the efficacy of bi-level positive airway pressure ventilation (BiPAP)and nal-oxone for the treatment of chronic obstructive pulmonary disease (COPD) in acute exacerbation combined with pulmonary encephalopathy. Methods:Sixy-six cases with COPD in acute exacerbation combined pulmonary encephalopathy were divided into two groups. 33 cases in control group were treated with oxygen inhalation, anti-infection and so on ;33 cases treated with BiPAP combined with naloxone on the basis of conventional treatment, naloxone 0.8mg intravenous injection for the first time,and then 3ug/kg·h by micro pump continous injection. PH, PaO2, PaCO2 and SaO2 before and after treat-ment in two groups were compared, and the change of HR, RR, MAP and clinical symptoms were observed. The hospitalization time, intubation rate and mortality rate were also observed.Results:After treatment, HR, RR and blood pressure were obviously improved in two groups.Whereas PaO2 and SaO2 were obviously increased in control group in 3h (P<0.05).But pH and PaCO2 were not obviously changed (P>0.05),some cases even worse; PaO2 and SaO2 were maintained at a high level in 24h, pH and PaCO2 were not obviously improved. The improvement of each index in observation group was obviously higher than that in control group after treatment, the difference had statistical significance(P<0.05). Compared with control group, observation group had shorter hospitalization time, lower intubation rate and mortality rate. The difference was obvious and had statistical significance(P<0.05). Conclusion:The treatment of COPD combined with pulmonary encephalopathy by BiPAP and naloxone has obvious cura-tive effect. It can obviously decrease the intubation rate and mortality rate.
