A randomized control trial of noninvasive positive pressure ventilation combined with naloxone in the treatment of acute exacerbations of chronic obstructive pulmonary diseases with pulmonary encephalopathy

Objective To observe the therapeutic effect of noninvasive positive pressure ventilation(NPPV) combined with naloxone in treatment of acute exacerbation of chronic obstructive pulmonaiy disease(AECOPD) complicated with pulmonary encephalopathy.Methods Seventy-eight cases of AECOPD patients with pulmonary encephalopathy were randomly divided into 2 groups,39 cases in observation group,on the basis of comprehensive therapy,using NPPV combined with naloxone in treatment;39 cases in the control group,without naloxone,other treatment was same as the observation group.The2 groups were observed the success rate and failure rate,and 3 d respiratory frequency(RR),heart rate(HR),pulse oxvgen saturation(SpO,),end tidal carbon dioxide partial pressure(P_(ET)CO_2) and changes of arterial blood gas indexes were compared before and after treatment.Results(1) Observation groups total success rate(92.3%) is higher than the control group(84.69%),but no significant differences between the 2 groups were found(P 0.05);(2) Compared with before treatment,alter 3 day treatment.RR and HR were improved in both of the 2 groups(P 0.01),no significant difference were found between the 2 groups(P 0.05).Comparison of respiratory score of before treatment and after treatment,both of the observation group[(1.70 ± 0.61) vs.(2.78 ± 0.64)]and the control group[(1.72 ±0.58) vs.(2.44 ±0.33)]were improved significantly(P 0.05),after treatment,there were significant difference between the 2 groups(P 0.05).(3) Compared with before treatment,after 3 days treatment,observation group's pH,SaO_2,PaO_2,PaCO_2,SpO,,Pi:1 CO,group were improved;in the control group,except SpO_2,other indicators also improved(P 0.05.P0.01).pH、PaCO_2、P_(ET)CO_2 were significant differences between the 2 groups(P 0.01).Conclusion The NPPV in treatment ol AECOPD with pulmonary encephalopathy has good effect;early naloxone combined with respiratory stimulant can significantly improve the therapeutic effect,improve the success rate,and reduce the rate of endotracheal intubation and mortality.