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目的:探讨尼可刹米与纳洛酮分别联合无创正压通气治疗慢性阻塞性肺疾病急性加重(AECOPD)并发呼吸衰竭的临床疗效。方法:收取2014年1月至2015年12月间我院收治的AECOPD并发呼吸衰竭患者98例,随机分为两组。对照组给予尼可刹米联合无创正压通气治疗,观察组给予纳洛酮联合无创正压通气治疗。对两组患者临床疗效、生命体征、动脉血气以及临床结果进行考察与比较。结果:观察组治疗总有效率为95.92%,对照组总有效率为91.84%,两组比较差异无统计学意义(P>0.05)。治疗前两组患者生命体征及动脉血气均无显著差异,治疗后两组各指标均有所改善,观察组改变幅度更加明显(P<0.05)。两组患者平均住院时间、气管插管率及不良反应发生率相比均无显著差异(P>0.05)。结论:尼可刹米与纳洛酮分别联合无创正压通气治疗AECOPD并发呼吸衰竭疗效及安全性相当,但纳洛酮对于患者生命体征及动脉血气改善均有更好的作用。
Objective: To investigate the clinical efficacy of nicorandil and naloxone in combination with non-invasive positive pressure ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure. Methods: A total of 98 patients with AECOPD complicated with respiratory failure admitted to our hospital from January 2014 to December 2015 were randomly divided into two groups. The control group was treated with Nicoramide combined with noninvasive positive pressure ventilation. The observation group was given naloxone combined with noninvasive positive pressure ventilation. The clinical efficacy, vital signs, arterial blood gas and clinical results of two groups of patients were investigated and compared. Results: The total effective rate was 95.92% in the observation group and 91.84% in the control group. There was no significant difference between the two groups (P> 0.05). Before treatment, there was no significant difference in vital signs and arterial blood gas between the two groups. After treatment, the indexes of both groups were improved, and the changes in the observation group were more obvious (P <0.05). There was no significant difference between the two groups in the average length of hospital stay, tracheal intubation rate and incidence of adverse reactions (P> 0.05). Conclusion: Niconkol and naloxone combined with noninvasive positive pressure ventilation are effective and safe in treating AECOPD complicated with respiratory failure. However, naloxone has a better effect on vital signs and arterial blood gas.