多巴胺和多巴酚丁胺治疗小儿重症肺炎合并心力衰竭的疗效观察

Observation on the effect of dopamine and dobutamine on Children with severe pneumonia complicated by heart failure

目的观察多巴胺和多巴酚丁胺治疗小儿重症肺炎合并心力衰竭的治疗效果。方法 2015年1月至2016年1月湖南省儿童医院儿科ICU病房收治的重症肺炎合并心力衰竭患儿70例,随机分为观察组和对照组各35例。对照组采用强心剂、抗生素、氧疗等常规治疗措施,观察组在常规治疗基础上给予多巴胺、多巴酚丁胺治疗。治疗前后对患儿的肌钙蛋白、肌酸激酶同工酶(CK-MB)、B型纳尿肽(BNP)水平检测,观察两组治疗效果。结果观察组总有效率为97.2%(34/35),显著高于对照组77.2%(27/35),差异有统计学意义(P<0.05)。观察组BNP、肌钙蛋白、CK-MB水平显著低于对照组,差异有统计学意义(P<0.05);观察组患儿症状消失时间、住院时间均低于对照组,差异有统计学意义(P<0.05)。结论对合并心力衰竭的重症肺炎患儿在常规对症治疗基础上,用多巴胺、多巴酚丁胺联合治疗能更好调整患儿相关临床指标,缓解患儿症状时间更短,缩短住院时间,保障患儿治疗依从性和其家庭经济负担。

Objective To observe the therapeutic effect of dopamine and dobutarnine on children with severe pneumonia complicated with heart failure. Methods Seventy patients with severe pneumonia complicated with heart failure were admitted to the ICU of Hunan Children＇s Hospital from January 2015 to January 2016, and were randomly divided into observation group and control group, with 35 cases in each group. The control group was routinely treated with tonic, antibiotics and oxygen therapy. The observation group was treated with dopamine and dobutamine on the basis of routine treatment. The levels of troponin, creatine kinase isoenzyme（CK-MB） and Btype natriuretic peptide（BNP） were measured before and after treatment, and the therapeutic effect was observed. Results The total effective rate was 97.2%（34/35） in the observation group, significantly higher than the control group（77.2 %, 27/35）, and these was statistical difference（P〈0.05）. The levels of BNP, troponin and CKMB in the observation group were significantly lower than those in the control group（P〈0.05）. The time for symptoms to disappear and the hospitalization time in the observation group were lower than those in the control group（P〈 0.05）. Conclusion Dopamine combined with dobutarnine can better improve the clinical indexes of children with severe pneumonia complicated with heart failure on the basis of conventional symptomatic treatment, and alleviate the symptoms of children in a shorter time. It shortens the hospitalization time, ensures the children compliance with treatment and reduces their family financial burden.