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目的探讨呼吸兴奋剂联合无创通气对慢性阻塞性肺疾病急性加重(AECOPD)患者酸碱平衡与电解质的影响。方法选取成都市第二人民医院2013年1月—2015年1月收治的AECOPD患者50例,随机分为对照组与观察组,各25例。对照组予以无创性通气治疗,观察组在对照组基础上予以可拉明+洛贝林治疗,两组患者治疗疗程为7d。比较两组患者治疗前后血气分析指标〔p H值、动脉血二氧化碳分压(Pa CO2)、动脉血氧分压(Pa O2)〕、电解质(Na+、K+)及代谢性碱中毒发生情况。结果治疗前两组患者p H、Pa O2、Pa CO2比较,差异无统计学意义(P>0.05);治疗后观察组p H、Pa O2高于对照组,Pa CO2低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者Na+、K+比较,差异无统计学意义(P>0.05);治疗后观察组Na+高于对照组,K+低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者总代谢性碱中毒发生率比较,差异无统计学意义(P>0.05);治疗后观察组患者总代谢性碱中毒发生率高于对照组,差异有统计学意义(P<0.05)。结论呼吸兴奋剂联合无创通气治疗AECOPD易导致患者酸碱平衡紊乱和碱中毒,需严格控制呼吸兴奋剂的使用。
Objective To investigate the effects of respiratory stimulants combined with noninvasive ventilation on acid-base balance and electrolytes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Fifty patients with AECOPD admitted to Chengdu Second People’s Hospital from January 2013 to January 2015 were randomly divided into control group and observation group, with 25 cases in each group. The control group was treated with noninvasive ventilation. The observation group was treated with catecholamine + lobeline on the basis of the control group. The treatment duration of the two groups was 7 days. Blood gas analysis index (p H value, PaCO 2, Pa O 2), electrolyte (Na +, K +) and metabolic alkalosis were compared between the two groups before and after treatment. Results There was no significant difference in p H, Pa O2 and Pa CO2 between the two groups before treatment (P> 0.05). After treatment, the levels of p H and Pa O2 in the observation group were higher than those in the control group, and Pa CO2 was lower than that in the control group Statistical significance (P <0.05). There was no significant difference in Na +, K + between two groups before treatment (P> 0.05). After treatment, Na + in observation group was higher than that in control group and K + was lower than that in control group (P <0.05). There was no significant difference in the incidence of total metabolic alkalosis between the two groups before treatment (P> 0.05). After treatment, the incidence of total metabolic alkalosis in the observation group was higher than that in the control group (P < 0.05). Conclusion Respiratory stimulants combined with non-invasive ventilation AECOPD easily lead to acid-base balance disorders and alkalosis in patients, the need to strictly control the use of respiratory stimulants.