目的 探讨呼吸兴奋剂尼可刹米剂量与时间对慢性阻塞性肺病急性加重期治疗效果的影响.方法 80例慢性阻塞性肺病急性加重期合并Ⅱ型呼吸衰竭患者,给予常规治疗后,在无创呼吸机辅助通气的基础上,根据应用呼吸兴奋剂尼可刹米的剂量随机平分成4组,观察动脉血气参数pH值、氧分压(PaO2)、二氧化碳分压(PaCO2)的变化.结果 双水平无创呼吸机正压通气联合不同剂量的呼吸兴奋剂能够显著纠正患者的pH值即酸中毒,提高氧分压,降低二氧化碳分压.综合血气分析各指标的改善情况,选择应用1.125 g 每12 h一次可能更优于其他剂量,应用4 d比应用1 d效果更明显.结论 慢性阻塞性肺病急性加重期合并Ⅱ型呼吸衰竭患者,双水平无创呼吸机正压通气基础上应用呼吸兴奋剂尼可刹米是有效而安全的治疗方法;呼吸兴奋剂选择合适的剂量和时间对达到最佳的治疗效果非常重要.%Objective To investigate the effect of the dose and using-time of respiratory stimulant nikethamide on the treatment of acute exacerbation chronic obstructive pulmonary disease. Methods Eighty acute exacerbation chronic obstructive pulmonary disease combined with type II respiratory failure patients were treated with regular treatments including BiPAP ventilator-assisted ventilation, and divided equally into four groups according to the doses of respiratory stimulant nikethamide. The analysis of arterial blood gases was made. Results The treatment of BiPAP ventilator-assisted ventilation with different dose of respiratory stimulant nikethamide could significantly improve pH,increase partial pressure of oxygen and decrease partial pressure of carbon dioxide. The dose of 1. 125 g every 12 h nikethamide might be better than other doses, and treatment for four days was better than one day. Conclusion For acute exacerbation chronic obstructive pulmonary disease combined with type II respiratory failure patients, the treatment of BiPAP ventilator-assisted ventilation with different dose of respiratory stimulant nikethamide is safe and effective, and the dose and using-time of respiratory stimulant nikethamide is important for the treatment.
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