目的 觀察尼可剎米治療急性加重期慢性阻塞性肺疾?。ˋECOPD）并呼吸衰竭的臨床療效。方法 選取2013年1月-2017年1月漢中市人民醫(yī)院收治的AECOPD并呼吸衰竭患者110例，隨機分為對照組和治療組，每組各55例。對照組給予無創(chuàng)正壓通氣輔助治療。治療組在對照組治療基礎(chǔ)上靜脈滴注尼可剎米注射液，500 mL生理鹽水溶解2.25 g尼可剎米注射液。觀察兩組的臨床療效，同時比較兩組治療前后血氣分析指標(biāo)、呼吸頻率、FEV1%、mMRC評分的變化情況；比較兩組氣管插管率和住院時間。結(jié)果 治療后，對照組和治療組的總有效率分別為76.36%、90.91%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組pO₂、pH值均顯著升高，pCO₂顯著降低，同組治療前后差異有統(tǒng)計學(xué)意義（P<0.05）；治療后，治療組pCO₂均顯著低于同期對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組呼吸頻率、mMRC評分顯著降低，F(xiàn)EV1%明顯提高，同組治療前后差異有統(tǒng)計學(xué)意義（P<0.05）；治療后，治療組呼吸頻率、mMRC評分顯著低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。對照組和治療組的氣管插管率分別為29.09%、7.27%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。對照組和治療組平均住院時間比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 尼可剎米治療AECOPD并呼吸衰竭具有較好的臨床療效，可顯著改善患者的血氣指標(biāo)，降低mMRC評分、插管率和住院時間，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of nikethamide in treatment of chronic obstructive pulmonary disease acute exacerbation (AECOPD) with respiratory failure. Methods Patients (110 cases) with AECOPD with respiratory failure in Hanzhong People's Hospital from January 2013 to January 2017 were randomly divided into control (55 cases) and treatment (55 cases) groups. Patients in the control group were iv administered with non-invasive positive pressure ventilation. Patients in the treatment group were iv administered with Nikethamide Injection on the basis of the control group, and 2.25 g Nikethamide Injection was dissolved with 500 mL physiological saline. After treatment, the clinical efficacy was evaluated, and the changes of blood gas analysis indexes, respiratory frequency, FEV1%, mMRC scores in two groups before and after treatment were compared. Tracheal intubation rate and hospitalization time in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 76.36% and 90.91%, respectively, and there was difference between two groups (P<0.05). After treatment, pO₂ and pH in two groups were elevated, and pCO₂ was reduced, and the difference was statistically significant in the same group (P<0.05). After treatment, pCO₂ in the treatment group was lower than those in the control group at the same times of the treatment, and there was difference between two groups (P<0.05). After treatment, respiratory frequency and mMRC scores in two groups were reduced, and FEV1% was elevated, and the difference was statistically significant in the same group (P<0.05). After treatment, frequency and mMRC scores in the treatment group were lower than those in the control group, and there was difference between two groups (P<0.05). The tracheal intubation rates of control and treatment groups was 29.09% and 7.27%, respectively, and there was difference between two groups (P<0.05). The average hospitalization times in the control and the treatment groups were difference between two groups (P<0.05). Conclusion Nikethamide has clinical curative effect in treatment of AECOPD with respiratory failure, and can significantly improve the blood gas indexes, reduce mMRC scores, and also and reduce intubation rate and hospitalization time, which has a certain clinical application value.