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《Chinese Journal of Difficult and Complicated Cases》 2017-01
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Therapeutic effect of noninvasive ventilation combined with naloxone for treating chronic obstructive pulmonary disease with acute exacerbation combined with type Ⅱ respiratory failure

SHAO Boyun;ZHOU Weihua;ZHU Bojin;LIXiaolong;Department of Respiratory Medicine,Hai'an Hospital Affiliated to Nantong University;  
Objective To investigate the efficacy and clinical experience of using noninvasive ventilation combined with naloxone for treating chronic obstructive pulmonary disease(AECOPD) with acute exacerbation combined with type Ⅱ respiratory failure.Methods From January 2013 to December 2015,in People Hospital of Hai' an County,90 patients with AECOPD combined with type Ⅱ respiratory failure were chosen as research subjects,according to the method of treatment,they were randomized into observation group(n =52) and control group(n =38);control group received conventional treatment,observation group received noninvasive ventilation on its basis combined with naloxone treatment,then observing efficacy and clinical experience.Results The total effective rate in the observation group was significantly higher than that in the control group(98.1%vs.79.0%,x~2=8.927,P = 0.003).After treatment,the degree of improvement of clinical symptoms such as respiratory rate,heart rate,FEV_1/FVC%and dyspnea score was much better than control group(t =6.668,t =6.272,t =6.192,t =6.597,all P 0.05).The degree of blood analysis index improvement of SPO_2,PaO_2,PaCO_2,pH in observation group was significantly better than that in the control group(t =6.616,t =6.931,t =6.315,t =6.219,all P 0.05).The trachea]intubation rale and the exacerbation rate within 6 months were significantly lower in observation group than that in control group(x~2 =6.583,x~2 =6.467,all P 0.05).There was no significant difference in the incidence of adverse reactions between two groups(x~2 = 1.134,P =0.102).Conclusion Using noninvasive ventilator joint naloxone to treat AECOPD patients with type Ⅱ respiratory failure can significantly improve the clinical symptoms,activity tolerance and heart and lung function,improve the quality of patients' lives and reduce the invasive ventilator utilization and reduce the frequency ol exacerbation.It is ol high security,and worthy ol promotion and application in clinical practice.
【Fund】: 2014年度南通市科技计划(指导性)项目(HS149157)
【CateGory Index】: R563.9;R563.8
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