多巴胺联合多巴酚丁胺辅助治疗小儿重症肺炎的临床疗效

Clinical effect and safety of low-dose dopamine combined with dobutamine in treatment of children with severe pneumonia

目的观察小剂量多巴胺联合多巴酚丁胺辅助治疗小儿重症肺炎的临床效果。方法将134例重症肺炎患儿随机分为两组,对照组(n=67)给予抗感染、吸氧、糖皮质激素、纠正酸碱失衡与电解质紊乱等常规治疗,观察组(n=67)在对照组治疗方案基础上加用小剂量多巴胺+多巴酚丁胺辅助治疗;比较两组患儿的临床效果和不良反应。结果观察组的临床总有效率高于对照组(P<0.05);观察组的主要症状、体征缓解时间优于对照组(P均<0.05);两组患儿治疗后的炎性细胞因子(TNF-α、IL-6、CRP)均较治疗前显著改善(P均<0.05),但观察组的改善幅度优于对照组(P均<0.05);两组患儿的不良反应发生率差异不显著(P>0.05)。结论小剂量多巴胺联合多巴酚丁胺辅助治疗小儿重症肺炎的临床效果显著,能够改善患儿的血气指标和血清炎性细胞因子水平,且未增加不良反应,建议临床推广。

Objective To observe the clinical effect of low-dose dopamine combined with dobutamine in treatment of children with severe pneumonia, and to evaluate the safety. Methods 134 children with severe pneu- monia were divided into two groups randomly. The control group （n = 67） was treated with anti-inflammation, oxygen inhalation, glucocorticoid, correcting acid-base imbalance and electrolyte disturbance, and the observation group （n = 67） was additionally treated with low-dose dopamine combined with dobutamine. The clinical effect and adverse reaction of the two groups were compared. Results The total clinical effective rate of the observation group was higher than that of the control group （P 〈 0. 05）. The remission time of symptoms and signs of the observation group were better than those of the control group （P 〈 0.05 ）. The inflammatory cytolines of the two groups improved evidently after treatment （P 〈 0. 05）, but the improvement was more pronounced in the observation group than in the control group （ P 〈0. 05 ）. The difference of the incidence of adverse reactions between the two groups was not evident （P 〉 0. 05）. Conclusion Low-dose dopamine combined with dobutamine treating children with severe pneumonia has evident clinical effect, which not only can improve blood gas index and serum inflammatory cytokines level, but also wont increase adverse reactions. It is worthy of widely clinical promotion.