婴幼儿支气管肺炎合并心力衰竭的血液动力学改变及治疗研究

A STUDY ON THE HEMODYNAMICCHANGE AND TREATMENT OF INFANTSAND TODDLERS WITH PNEUMONIA COM-PLICATED WITH HEART FAILURE

报告２７例婴幼儿重症肺炎并心力衰竭（简称心衰）与２７例同龄健康儿童配对对比，其心脏指数（ＣＩ）、主动脉最大流速（ＰＦＶＡ）、肺动脉最大流速（ＰＦＶＰ）显著下降，二尖瓣Ｅ峰最大流速（ＰＦＶＭＥ）、三尖瓣Ｅ峰最大流速（ＰＦＶＴＥ）显著增加。２１例肺炎心衰患儿用酚妥拉明治疗前后对比，ＰＦＶＰ、ＰＦＶＡ、ＣＩ显著增加．ＰＦＶＴＥ、ＰＦＶＭＥ无显著改变。２０例肺炎心衰患儿用地高辛治疗前和治疗后２４小时、４８小时对比，Ｃｌ、ＰＦＶＡ、ＰＦＶＰ显著增加，ＰＦＶＭＥ、ＰＦＶＴＥ显著减小。提示对肺炎心衰患儿，除血压下降者外，可先用酚妥拉明，随之开始用地高辛治疗，可取得满意疗效。

AbstractHemodynarnic changes of 27 infants and toddlerswith severe pneumonia coniplicatetl with heart failureand 27 normal children of sanie ages were compared.In the pneurnonia group, cardiae index(CI), peakflow velocity of pulmonary valve(PFVP)and peak flowvelocrty of aortic valve (PFVA)were significantly de-creased and peak flow velocity of mitral valve E wave(PFVME)and peak flow velocity of tricuspid valve Ewave(PFVTE)were significantly increased. compar-ing the hernodynaniic changes of 21 pediatric patientswith pneumonia complicated with heart failure beforeand one hour after administration of nhentolanune, wefound that CI. PFVP but PFVA were significantly in-creased and PFVTE and PFVME did not, In 20, thehemodynamic changes were observed before and 24hours, 48 hours after digoxin was used: the resultsshowed that CI. PFVA and PFVP were significantlyincreased and PFVME and PFVTE were significantlydecreased.