目的 观察尼克刹米在慢性阻塞性肺疾病伴呼吸衰竭患者通气治疗中的临床效果及对血气指标、炎性因子的影响.方法 选取2015年7月—2017年7月陕西省宝鸡人民医院呼吸内科收治慢性阻塞性肺疾病伴呼吸衰竭患者92例作为研究对象,随机数字表法分为观察组46例和对照组46例.对照组无创呼吸机治疗,观察组在对照组基础上加用尼可刹米,2组疗程均为7 d.比较2组患者临床效果,治疗前后炎性因子水平、肺功能、血气指标,并比较2组患者气管插管率、住院时间、病死率.结果 观察组总有效率显著高于对照组(95.7%vs.82.6%,χ2=4.039,P=0.044);治疗后观察组TNF-α、IL-6、IL-1β水平显著低于对照组(t=5.643、9.669、3.858,P均=0.000);观察组FVC、FEV1、MVV、PEF、PaO2、CaO2水平显著高于对照组(t=14.387、6.782、6.188、6.947、3.923、6.959,P均=0.000),VO2、PaCO2显著低于对照组(t=6.819、7.529,P均=0.000);观察组气管插管率、住院时间、病死率明显低于对照组(χ2=5.456,t=5.546,χ2=5.646;P=0.019、0.000、0.017).结论 尼克刹米应用于慢性阻塞性肺疾病伴呼吸衰竭患者通气治疗中能够提高临床效果,改善血气指标,提高肺功能,可作为慢性阻塞性肺疾病伴呼吸衰竭治疗的选择药物之一.%Objective To investigate the effect of nikethamide on blood gas index in patients with COPD and respira-tory failure. Methods Ninety-two patients with COPD and respiratory failure who were treated in hospital from July 2015 to July 2017 were selected. Patients were divided into study group (46 cases) and control group (46 cases). The patients of control group were treated with non-invasive ventilator. Based on the control group,the patients of study group were treated with nikethamide. The patients of 2 groups were all treated for 7 days. Compare the clinical effect,changes of inflammatory factors,pulmonary function and blood gas indexes,tracheal intubation rate,hospitalization time,mortality of two groups. Re-sults After the appropriate treatment,the total control rate of the study group was 91. 3%,which was significantly higher than 84. 8% of the control group (χ2 =4. 039, P=0. 044). After treatment,the levels of TNF-α, IL-6 and IL-1β in the study group were significantly lower than those in the control group (t=5. 643, t=9. 669, t=3. 858, P=0. 000, P=0. 000, P=0. 000). The levels of FVC, FEV1, MVV, PEF in the study group were significantly higher than those in the control group (t=14. 387, t=6. 782, t=6. 188, t=6. 947, P=0. 000, P=0. 000, P=0. 000, P=0. 000). The PaO2,CaO2 levels in the study group were significantly higher than those in the control group,and the VO2 ,PaCO2 levels in the study group were significantly lower than those in the control group (t=3. 923, t=6. 959, t=6. 819, t=7. 529, P=0. 000, P=0. 000, P=0. 000, P=0. 000). The tracheal intubation rate,hospital stay,mortality in the study group was significantly lower than those in the control group (χ2 =5. 456,χ2 =5. 546,χ2 =5. 646, P=0. 019, P=0. 000, P=0. 017). Conclusion Nikethamide used in COPD patients with respiratory failure can improve clinical outcomes,improve blood gas index and lung function,which can be used as a chronic obstructive pulmonary disease with respiratory failure treatment options.
展开▼
