应用米力农治疗手足口病重症并发循环系统障碍的护理

Care study on application of milrinone in severe hand,foot and mouth disease complicated with circulation obstruction

目的探讨应用米力农治疗手足口病重症合并循环系统障碍的疗效和护理方法。方法对157例手足口病重症合并循环系统障碍的患儿应用米力农治疗,针对药物特点在护理过程中严密观察病情,监测患儿心率、呼吸、收缩压、舒张压及血氧饱和度(SPO_2)等循环系统功能指标的变化。结果心率、呼吸、收缩压、舒张压及SPO_2等各项指标在米力农泵入10 min、1 h和2h后与泵入前相比差异均有统计学意义(P均<0.05)。心率、呼吸逐渐减慢,收缩压、舒张压逐渐降低,SPO_2逐渐升高。结论应用米力农治疗手足口病重症并发循环系统障碍疗效显著,对于有循环系统异常征兆的患儿在工作中早期发现,及早(10 min)使用米力农进行干预,因为泵入后10 min与泵入前的相关性最强,相关系数最大。根据患儿的病情调整米力农药物的剂量和速度,严格无菌操作,加强病情观察与护理监测,对疗效起着极其重要的作用。

Objective To explore the effect of milrinonein on treating hand,foot and mouth disease（HFMD） complicated by circulatory system disorders,and the optimal nursing methods.Methods Milrinone was applied to 157 HFMD cases complicated with circulatory system disorders.According to the characteristics of the drug,the state of disease was strictly observed during nursing process,by monitoring circulatory system function changes of heart rate,breathing,systolic pressure,diastolic pressure,pulse oxygen saturation（SPO_2） and so on.Results Compared with before treatment,there were significant differences（P all 〈0.05） in the indexes of heart rate,breathing,systolic pressure,diastolic pressure and SPO_2 with milrinone pumped for 10 minutes,1 hour and 2 hours.Heart rate and breathing gradually slowed down,systolic pressure and diastolic pressure gradually decreased,and SPO_2 increased gradually.Conclusions Application of milrinone in treatment of HFMD complicated by circulatory system disorders had curative effect.It＇s of vital importance to find the children with abnormal signs of circulatory system early and interrupt with milrinone early（10 minutes）,because the correlation between pumped 10 minutes and before is the strongest,and the correlation coefficient is significant.Adjusting the dose and speed of milrinone according to the situation of the disease,strict aseptic manipulation,strengthening the observation and nursing monitoring also play a very important role on the curative effect.