多巴胺、酚妥拉明、重组干扰素α联合NCPAP治疗婴幼儿重症毛细支气管炎的疗效观察

Observation on effect of dopamine,phentolamine,recombinant interferonαcombined with NCPAP in treating severe infantile bronchiolitis

目的探讨多巴胺、酚妥拉明、重组干扰素α联合经鼻持续气道正压通气(NCPAP)治疗婴幼儿重症毛细支气管炎的临床效果。方法婴幼儿重症毛细支气管炎患儿分为观察组55例和对照组40例,对照组患儿给予多巴胺、酚妥拉明、重组干扰素α联合方案治疗,观察组患儿在此基础上加用NCPAP,比较两组治疗效果。结果观察组患儿总有效率显著高于对照组,患儿体温恢复时间、憋喘消失时间、咳嗽停止时间、肺部哮鸣音消失时间、住院时间显著低于对照组,差异有统计学意义(P<0.05)。两组患儿治疗后呼吸频率、心率、PaCO_2水平显著低于治疗前,PaO_2、PaO_2/FiO_2、pH水平显著高于治疗前,差异有统计学意义(P<0.05);观察组患儿治疗后呼吸频率、心率、PaCO_2水平显著低于对照组,PaO_2、PaO_2/FiO_2、pH水平显著高于对照组,差异有统计学意义(P<0.05)。两组患儿治疗后血清白细胞介素-8(IL-8)、可溶性血管细胞间黏附分子-1(sVCAM-1)及尿白三烯E4(LTE4)水平均显著低于治疗前,差异有统计学意义(P<0.05);两组患儿治疗后血清IL-8、sVCAM-1及尿LTE4水平对比,差异无统计学意义(P>0.05)。观察组患儿复发率和病死率显著低于对照组,差异有统计学意义(P<0.05);两组治疗期间不良情况发生率对比,差异无统计学意义(P>0.05)。结论多巴胺、酚妥拉明、重组干扰素α联合NCPAP治疗婴幼儿重症毛细支气管炎临床效果显著,可有效改善患儿血气分析指标,缩短症状体征缓解时间,降低复发率和病死率,临床应用价值较高。

Objective To explore the clinical effect of dopamine,phentolamine,recombinant interferon a combined with nasal continuous positive airway pressure（CPAP） ventilation in treating severe infantile bronehiolitis. Methods Ninety-five cases of in- fantile severe bronchiolitis were divided into the observation group（55 cases） and control group （40 cases）. The control group was given the combined treatment scheme of dopamine, phentolamine and recombinant interferon while on this basis the observation group was added with NCPAP. The curative effects were compared between the two groups. Results The total effective rate in the observation group was significantly higher than that in the control group（P〈0.05） ;the temperature recovery time, wheezing disap- pearance time, cough stopping time,tung wheezing sound disappearance time and hospitalization time in the observation group were significantly lower than those in the control group（P〈0.05） ;the breathing rate, heart rate and PaCO2 level after treatment in the two groups were significantly lower than those before treatment, the levels of PaO2, PaO2/FiO2 and pH were significantly higher than those before treatment in the same group, the differences were statistically significant（P〈0.05） the breathing rate,heart rate and PaCO2 level after treatment in the observation group were significantly lower than those in the control group（P〈0.05）;the levels of PaO2, PaO2/FiO2 and PH after treatment in the observation group were significantly higher than those in the control group （P〈0.05） ;the levels of IL-81 sVCAM-land LTE4 after treatment in the two groups were significantly lower than those before treatment （P〈0.05）;there was no statistically significant difference in the levels of serum IL-8, sVCAM-1 and urine LTE4 between the two groups（P〉0.05）;the recurrence rate and death rate in the observation group were significantly lower than those in the control group with statistical difference（P〈0. 05） ;the occurrence rate of adverse situation during treatment period had no statisti cal difference between the two groups（P〉0.05）. Conclusion Dopamine, phentolamine, recombinant interferon a combined with NCPAP has obviously clinical effect for treating infantile severe bronchiolitis,can effectively improve the blood gas analytical inde- xes, reduces the signs and symptoms relief time, reduces the rates of relapse and death, and has higher clinical application value.