清开灵注射液联合纳洛酮辅助治疗慢性阻塞性肺疾病合并肺性脑病的临床观察

发布时间：2018-11-05 13:09

【摘要】：目的:观察清开灵注射液联合纳洛酮辅助治疗慢性阻塞性肺疾病(COPD)合并肺性脑病的临床疗效和安全性。方法:80例COPD合并肺性脑病患者随机均分为对照组和观察组。对照组患者给予双水平无创正压通气、常规吸氧、抗感染、化痰平喘等常规治疗;观察组患者在对照组治疗的基础上给予清开灵注射液40~60ml,静脉滴注,30~40滴/min,qd+注射用盐酸纳络酮0.8mg,静脉注射,后再给予注射用盐酸纳络酮2mg,连续24h微量泵入。两组患者均连续给药3d。观察两组患者的临床疗效,治疗前后动脉血氧分压(pO2)、二氧化碳分压(pCO2)、酸碱度(pH)、心排出量(CO)、心脏指数(CI)、格拉斯哥昏迷(GCS)评分、平均住院时间、气管插管率及不良反应发生率。结果:观察组患者总有效率显著高于对照组,平均住院时间、不良反应发生率显著低于对照组,差异均有统计学意义(P0.05)。治疗后,两组患者pO2、pH、GCS评分均显著高于同组治疗前,且观察组高于对照组,pCO2显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P0.05);两组患者治疗前后CO、CI及气管插管率比较,差异均无统计学意义(P0.05)。结论:在常规治疗的基础上,清开灵注射液联合纳洛酮治疗COPD合并肺性脑病疗效和安全性均较好。
[Abstract]:Objective: to observe the efficacy and safety of Qingkailing injection combined with naloxone in the treatment of chronic obstructive pulmonary disease (COPD) with pulmonary encephalopathy. Methods: 80 COPD patients with pulmonary encephalopathy were randomly divided into control group and observation group. The patients in the control group were treated with bi-level non-invasive positive pressure ventilation, routine oxygen inhalation, anti-infection, phlegm and asthma. The patients in the observation group were given Qingkailing injection 4060 ml, intravenous drip, 30g 40 drops / min,qd injection of naloxone hydrochloride 0.8 mg, intravenous injection of naloxone hydrochloride 2 mg, continuous 24 h micropump. The patients in both groups were treated continuously for 3 days. The clinical efficacy, arterial partial pressure of oxygen (pO2), partial pressure of carbon dioxide (pCO2), pH, (pH), cardiac output, (CO), cardiac index, (CI), Glasgow coma (GCS) score before and after treatment were observed. Mean hospitalization time, tracheal intubation rate and adverse reaction rate. Results: the total effective rate in the observation group was significantly higher than that in the control group, the average hospitalization time and the incidence of adverse reactions were significantly lower in the observation group than in the control group (P0.05). After treatment, the pO2,pH,GCS scores of the two groups were significantly higher than those of the same group before treatment, and the observation group was higher than the control group, the pCO2 was significantly lower than the same group before treatment, and the observation group was lower than the control group, the difference was statistically significant (P0.05). There was no significant difference in CO,CI and tracheal intubation rate between the two groups before and after treatment (P0.05). Conclusion: on the basis of routine treatment, Qingkailing injection combined with naloxone is effective and safe in the treatment of COPD with pulmonary encephalopathy.
【作者单位】：浙江长广集团有限责任公司职工医院;杭州市第一人民医院;
【分类号】：R563.9

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