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目的：探讨尼可刹米与纳洛酮分别联合无创正压通气治疗慢性阻塞性肺疾病急性加重(AECOPD)并发呼吸衰竭的临床疗效。方法：收取2014 年1 月至2015年12月间我院收治的AECOPD 并发呼吸衰竭患者98 例，随机分为两组。对照组给予尼可刹米联合无创正压通气治疗，观察组给予纳洛酮联合无创正压通气治疗。对两组患者临床疗效、生命体征、动脉血气以及临床结果进行考察与比较。结果：观察组治疗总有效率为95.92 %，对照组总有效率为91.84 %，两组比较差异无统计学意义（P>0.05）。治疗前两组患者生命体征及动脉血气均无显著差异，治疗后两组各指标均有所改善，观察组改变幅度更加明显（P<0.05）。两组患者平均住院时间、气管插管率及不良反应发生率相比均无显著差异（P>0.05）。结论：尼可刹米与纳洛酮分别联合无创正压通气治疗 AECOPD 并发呼吸衰竭疗效及安全性相当，但纳洛酮对于患者生命体征及动脉血气改善均有更好的作用。

英文摘要:

Objective:To explore the effect of nikethamide and naloxone combined with non invasive positive pressure ventilation (NIPPV) respectively in the treatment of acute exacerbation of Chronic Obstructive PulmonaryDisease (AECOPD) with respiratory failure.Methods:98 AECOPD patients with respiratory failure accepted in our hospital from January 2014 to December 2015 were randomly divided into two groups. The patients in control group were given nikethamide combined with NIPPV, and the patients in observation group were given naloxone combined with NIPPV. Then the clinical effect, vital signs, ABG and clinical results of two groups were observed and compared.Results:The total efficacy of observation group and control group was respectively 95.92 % and 91.84 %, which had no statistically significance between two groups (P>0.05). The vital signs and ABG of two groups had no difference before treatment, but all indexes were getting better after treatment, and it was more obviously in observation group than control group (P<0.05). The average hospital stays, the rate of endotracheal intubation and adverse reactions had no statistically difference between two groups (P>0.05).Conclusion:Using nikethamide and naloxone combined with NIPPV respectively has same effect and safety in the treatment of AECOPD with respiratory failure, but naloxone has a better effect on the improvement of vital signs and ABG.

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