尼可刹米在慢性阻塞性肺疾病合并肺性脑病中的应用

Application of Nikethamide in chronic obstructive pulmonary disease with pulmonary encephalopathy

摘要:

目的  探讨尼可刹米在无创正压通气（NIPPV）治疗慢性阻塞性肺疾病（COPD）合并肺性脑病中的应用价值。方法  选择86例COPD合并肺性脑病患者，随机分为治疗组和对照组各43例。两组均予抗感染、祛痰、抗炎、解痉等常规治疗及NIPPV，治疗组加用呼吸兴奋剂尼可刹米，以5 mg/min的速度持续泵入，连用72 h。比较两组患者血气分析、住院时间及临床转归。结果  治疗后两组患者动脉血气及格拉斯哥评分（GCS评分）均较治疗前改善（P <0.05），治疗组改善优于对照组（P <0.05），治疗组气管插管率低于对照组（P <0.05），无创通气时间（好转脱机）及平均住院时间短于对照组（P <0.05），死亡率低于对照组（P <0.05）。结论  在NIPPV的基础上加用尼可刹米，可改善COPD合并肺性脑病患者的预后，具有良好的治疗作用。

Abstract:

Objective To investigate the application value of Nikethamide in the treatment of non-invasive positive pressure ventilation (NIPPV) in patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary encephalopathy. Methods Totally 86 COPD patients complicated with pulmonary encephalopathy were divided into treatment group and control group according to random principle, with 43 cases in each group. Both groups accepted NIPPV and conventional treatment including anti-infection, expectorant anti-inflammation and spasmolysis; in addition, the treatment group used respiratory stimulant Nikethamide, continuous pumping at a speed of 5 mg/min for 72 hours. Blood gas analysis, duration of hospital stay and clinical outcome were compared between the two groups. Results After treatment, the arterial blood gas and Glasgow score (GCS score) were improved in both groups (P < 0.05) which was more obvious in the treatment group than in the control group (P < 0.05), the endotracheal intubation rate of the treatment group was lower than that of the control group (P < 0.05), and the time of noninvasive ventilation (improvement in offline) and average hospitalization was shorter than that of the control group (P < 0.05), the mortality rate was lower than that of the control group (P < 0.05). Conclusions On the basis of NIPPV, Nikethamide can improve the prognosis of patients with COPD complicated with pulmonary encephalopathy, and has a good therapeutic effect.