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目的观察纳洛酮治疗老年慢性肺源性心脏病合并肺性脑病的治疗效果。方法将入选80例病例随机分为治疗组及对照组各40例,对两组患者给予抗感染、持续氧流量为1～3L/min,低流量吸氧(给氧浓度为25%～35%),解痉平喘、止咳化痰、保持呼吸道通畅、维持酸碱、水电解质平衡、营养支持等综合治疗。治疗组在此基础上加用纳络酮注射液(0.4 mg/支),首剂负荷量0.8mg,加入5%葡萄糖20ml中静脉推注,连用3d。结果治疗组总有效率为85%,对照组总有效率为60%,两组疗效比较差异有统计学意义(P<0.05);治疗组pH值、PaO2、PaCO2均优于对照组,差异有统计学意义(P<0.01或P<0.05)。结论纳络酮治疗肺性脑病能降低PaCO2,提高PaO2和PH值。缩短患者的清醒时间,无明显不良反应,值得在临床上推广应用。
Objective To observe the therapeutic effect of naloxone on senile patients with chronic cor pulmonale complicated with pulmonary encephalopathy. Methods 80 cases were randomly divided into treatment group and control group, 40 cases were given anti-infective, continuous oxygen flow was 1 ~ 3L / min, low flow oxygen (oxygen concentration of 25% to 35% ), Antispasmodic and antiasthmatic, cough and phlegm, keep the airway clear, maintain the comprehensive treatment of acid-base, water and electrolyte balance, nutrition support and so on. On the basis of this treatment, the treatment group added naloxone injection (0.4 mg / support), the first dose of 0.8 mg, added 5% glucose 20 ml intravenous bolus, once every 3d. Results The total effective rate was 85% in the treatment group and 60% in the control group, the difference between the two groups was statistically significant (P <0.05). The pH, PaO2 and PaCO2 in the treatment group were better than those in the control group Statistical significance (P <0.01 or P <0.05). Conclusion Naloxone treatment of pulmonary encephalopathy can reduce PaCO2, increase PaO2 and PH value. Shorten the patient’s awake time, no significant adverse reactions, it is worth to promote the clinical application.