摘要目的:探讨持续双水平气道正压通气(BiPAP)联合纳洛酮治疗慢性阻塞性肺疾病急性加重期(AECOPD)伴呼吸衰竭的效果。方法:抽取2018年1月至2019年12月洛阳市第一人民医院收治的AECOPD伴呼吸衰竭患者82例，按照治疗方案分为两组，每组41例。观察组给予常规治疗、BiPAP及纳洛酮治疗，对照组给予常规治疗、BiPAP及尼可刹米治疗。回顾性比较治疗前后两组血气分析指标、肺功能指标、生活质量及不良反应。结果:治疗7 d，两组动脉血氧分压(PaO 2)、动脉血氧饱和度(SaO 2)、用力肺活量(FVC)、第1秒用力呼吸容积(FEV1)水平较治疗前升高( P<0.05)，动脉血二氧化碳分压(PaCO 2)水平较治疗前降低( P<0.05)，且观察组PaCO 2水平低于对照组( t＝5.097， P<0.05)，PaO 2、SaO 2、FVC、FEV1水平高于对照组( t＝3.335、4.327、3.862、2.858， P<0.05)；两组生活质量评分较治疗前降低，且观察组低于对照组( t＝9.070， P<0.05)。治疗期间，观察组不良反应总发生率2.44%(1/41)低于对照组的12.20%(5/41)，但χ 2＝1.618， P＝0.203。 结论:AECOPD伴呼吸衰竭采用BiPAP联合纳洛酮治疗，可有效改善肺功能及血气分析指标，提升患者的生活质量，且安全性较好。

abstractsObjective:To analyze the effect of continuous bi-level positive airway pressure (BiPAP) and naloxone in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure.Methods:A total of 82 patients with AECOPD and respiratory failure who were admitted to Luoyang First People’s Hospital from January 2018 to December 2019 were divided into two groups according to the treatment plan, with 41 cases in each group. The observation group was treated with conventional treatment, BiPAP and naloxone treatment, and the control group was treated with conventional treatment, BiPAP and nikethamide treatment. The blood gas analysis indexes, lung function indexes, quality of life and adverse reactions were compared retrospectively between the two groups before and after treatment.Results:After 7 days of treatment, the levels of partial pressure of oxygen in arterial blood (PaO 2), arterial oxygen saturation (SaO 2), forced vital capacity (FVC), and forced expiratory volume in 1st second (FEV1) of the two groups were higher than those before treatment ( P<0.05), and partial pressure of carbon dioxide in arterial blood (PaCO 2) level was lower than that before treatment ( P<0.05), and the PaCO 2 level of the observation group was lower than that of the control group ( t=5.097, P<0.05), and the levels of PaO 2, SaO 2, FVC and FEV1 were higher than those of the control group ( t=3.335, 4.327, 3.862, 2.858, P<0.05). The quality of life scores of the two groups were lower than those before treatment, and which of the observation group were lower than those of the control group ( t=9.070, P<0.05). During the treatment, the total incidence of adverse reactions of the observation group was 2.44% (1/41), which was lower than 12.20% (5/41) of the control group, but χ 2=1.618, P=0.203. Conclusions:AECOPD and respiratory failure is treated with BiPAP and naloxone, which can effectively improve the patients’ lung function and blood gas analysis indicators, improve their quality of life, and has higher safety.