目的:研究纳洛酮治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效.方法:选择我院呼吸内科收治的COPD合并Ⅱ型呼吸衰竭患者120例,随机分为治疗组和对照组,在常规治疗的基础上,治疗组加用纳洛酮0.8 mg加20 ml 5%葡萄糖注射液经静脉注射,然后加1.2 mg纳洛酮加250 ml 5%葡萄糖注射液,以0.4～0.8 mg/h的速度静脉滴注,疗程为5 d;对照组加用尼可刹米1.875～3.75 g加250～500 ml 5%葡萄糖注射液经静脉匀速滴注,疗程为7 d.结果:治疗前,两组血气分析差异无统计学意义(P>0.05).治疗后,治疗组PaO2[(89.21±11.46)mm Hg]显著高于对照组[(67.13±13.53)mm Hg],差异具有高度统计学意义(t=9.381,P<0.01),而治疗组PaCO2[(36.29±14.09)mm Hg]显著低于对照组[(57.63±13.82)mmHg],差异具有高度统计学意义(t=8.928,P<0.01).治疗组总有效率(86.67%)显著高于对照组(58.33%),差异高度有统计学意义(χ2=7.94,P<0.01).结论:纳洛酮治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭具有安全、高效、疗效稳定、耐受性佳等优势,可作为慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭治疗的优先方案.%Objective: To investigate the treatment effect of Nalaxon in the treatment of chronic obstructive pumlonary disease (COPD) and type Ⅱ chronic respiratory failure. Methods: 120 cases of COPD patients with type Ⅱ chronic respiratory failure were randomly divided into treatment group and control group. On the basis of routine treatment, patients in the therapy group were additionally given Naloxone 0.8 mg with 5％ glucose 20 ml injecta through vein and 1.2 mg Naloxone with 250 ml glucose intravenous drip with the speed of 0.4-0.8 mg/h, 5 days as a course. At the same time, the controlgroup were additionally given Nikethamide 1.875～3.75 g with 250-500 ml 5％ glucose injecta through vein, 7 days as acourse. Results: There was no significant difference in blood gas between two groups before treatment (P＞0.05). The PaO2 of therapy group [(89.21±11.46)mm Hg] was significantly higher than that of control group [(67.13 ±13.53)mm Bg] (t＝9.38, P＜0.01). Meanwhile, the PaCO2 of treatment group [(36.29±14.09)mm Hg] was obviously lower than that of control group [(57.63 ±13.82)mm Hg] (t＝8.928, P＜0.01). The total efficacy of treatment group (86.67％) was obviously higher than control group (58.33％)which show statistic significance (X2＝7.936, P＜0.01). Conclusion: Naloxone shows obvious advantages of safe, efficient, good tolerance in treatment of COPD combined with type Ⅱ chronic respiratory failure which can be recognized as a prior choice in the treatment.
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