目的 观察无创正压通气辅助纳洛酮联合红花黄色素对重症肺心病合并呼吸衰竭的疗效.方法 选取2014年10月-2015年9月海南省琼海市人民医院重症医学科收治的重症肺心病合并呼吸衰竭患者65例,根据随机数字表法分为观察组(33例)和对照组(32例).对照组采取常规药物综合治疗与无创正压通气治疗,观察组在此基础上加以纳洛酮联合红花黄色素进行治疗.检测患者治疗前后动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、血液酸碱度(pH)、心率、呼吸频率.观察患者的临床疗效和不良反应.结果 治疗后,观察组总有效率显著高于对照组(93.94% vs.71.88%,X2=23.633,P<0.01).观察组的PaO2显著高于对照组[(68.32±6.84)mmHg vs.(56.32±5.11)mmHg,t=7.994,P<0.01],PaCO2显著低于对照组[(46.43±4.11)mmHg vs.(69.43±5.43)mmHg,t=19.293,P<0.01].治疗后,观察组的心率、呼吸频率显著低于对照组[(101.11±4.32)次/min vs.(106.43±6.73)次/min、(21.43±0.25)次/min vs.(25.65±0.34)次/min,t=3.804、57.135,P均<0.01].观察组和对照组均未发生严重不良反应.结论 重症肺心病合并呼吸衰竭患者经无创正压通气辅助纳洛酮联合红花黄色素治疗,能降低PaCO2,提高PaO2,可减慢心率、呼吸频率,有利于患者临床症状的改善,临床疗效良好,安全性高.%Objective To observe effect of noninvasive positive pressure ventilation auxiliary joint naloxone with saffower yellower on severe cor pulmonale combination of respiratory failure.Methods From October 2014 to September 2015, selecting 65 cases of severe cor pulmonale combination of respiratory failure patients in the hospital, according to the random number method, patients were divided into observation group (33 cases) and control group (32 cases).Control group were taken regular medicine comprehensive treatment with noninvasive positive pressure ventilation therapy, observation group were treated with naloxone with saffower yellower for treatment on the basis of control group.Before and after treatment, patients with arterial blood oxygen partial pressure, arterial blood (PaO2), partial pressure CO2 (PaCO2), blood pH value (pH), heart rate and breathing rate were tested.The clinical efficacy and adverse reactions were observed.Results After treatment, the total clinical efficacy rate in the observation was significantly higher than the control group [93.94% (31/33) vs.71.88%(23/32),X2=23.633,P<0.01].PaO2 of observation group was significantly higher than control group [(68.32±6.84) mmHg vs.(56.32±5.11) mmHg], PaCO2 was significantly lower than the control group[(46.43±4.11) mmHg vs.(69.43±5.43) mmHg],the difference had statistical significance (t=7.994,t=19.293,P<0.01).After treatment, the observation group's heart rate, respiratory frequency were significantly lower than the control group[(101.11±4.32) times/min vs.(106.43±6.73) times/min;(21.43±0.25) times/min vs.(25.65±0.34) times/min,t=3.804,t=57.135,P<0.01].Observation group and control group rate of adverse reactions had no significant difference(P>0.05). Conclusion Severe cor pulmonale combination of respiratory failure treated with noninvasive positive pressure ventilation auxiliary joint naloxone with saffower yellower can reduce PaCO2,improve PaO2,can reduce the heart rate and breathing rate,it is conducive to the improvement of clinical symptoms, clinical curative effect is good with high safety.
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