小剂量多巴胺联合多巴酚丁胺治疗小儿重症肺炎的临床效果

Study on clinical effect of small dosage dopamine combined with dobutamine in treatment of patients withsevere pediatric pneumonia

目的探讨常规治疗小儿重症肺炎基础上给予小剂量多巴胺联合多巴酚丁胺的临床效果。方法选择2013年8月至2014年5月间收治的68例确诊为小儿重症肺炎患儿为研究对象,随入院时间先后分为治疗组及对照组各34例。观察治疗期间患儿体温、呼吸困难、心率及啰音及血气指标,治疗24 h后再次进行危重评分,治疗3 d后观察临床疗效和血气指标。结果经3 d治疗后,治疗组以总有效率94.12%明显优于对照组70.59%(P<0.05);治疗组体温、呼吸困难、心率、啰音症状消失时间均优于对照组(P<0.05);治疗组治疗24 h后危重评分及治疗3 d后血气分析指标均明显优于治疗前及对照组(P<0.05)。结论小剂量多巴胺联合多巴酚丁胺治疗小儿重症肺炎,可避免气道损伤、感染等弊端,且可兴奋呼吸中枢,提高治疗疗效、迅速改善临床症状,值得临床推广。

Objective To explore the clinical efficacy of small dosage dopamine and dobutamine on thebasis of conventional therapy in treatment of children with severe pneumonia. Methods A total of 68 pediatricpatients with severe pneumonia admitted in this hospital during August 2013 to May 2014 were divided into studygroup and control group,each group with 34 cases. The temperature,difficulty in breathing,heart rate and rales and blood gas indexes in patients were observed during the whole therapeutic course,the critical scoring had been evaluated after treatment for 24 h and compared with those before the treatment. Results After treatment for 3 d,the total efficacy of patients in study group was94. 12%,it was better than that（ 70. 59%） of control group（ P〈0. 05）. Theremittence in fever,breathing difficulties,heart rate and the disappearance time for rales in patients of study groupwere better than those of patients in control group（ P〈0. 05）. The critical scores in patients of study group treated for 24 h and the blood gas analysis after treatment for 3 days were significantly better than those before treatment andcontrol group（ P〈0. 05）. Conclusion The application of small dosage of dopamine and dobutamine in treatment ofpediatric patients with severe pneumonia can avoid the airway injury,infection and sleep apnea,and it may improvethe efficacy of treatment with rapid improvement of clinical symptoms,hence it is worthy to be clinically promoted.