米力农雾化疗法在重症肺部感染并发心力衰竭患儿中的应用效果评价

Effect of milrinone nebulization therapy in children with severe pulmonary infections complicated with heart failure

目的探讨米力农雾化疗法在重症肺部感染并发心力衰竭儿童中的应用效果,为临床治疗提供理论依据。方法选择2013年6月-2016年6月医院就诊的重症肺部感染并发心力衰竭患儿86例,按照随机数表法将患儿分为研究组和对照组,各43例,对照组患儿给予基础治疗,研究组在对照组的基础上给予米力农雾化疗法,观测两组患儿治疗前后的心率、面色转红润时间、精神状况、肺部啰音消失时间、哺乳时间、肝脏缩小时间等体征情况;比较两组患儿症状、体征改善时间、治疗有效率,观察并记录两组患儿药物副作用,测量两组患儿左室收缩末径(LVSD)、左室舒张末径(LVDD)、房室瓣EA峰比值(E/A)、左室短轴缩短率(LVSF)、动脉收缩压(SAP)、平均肺动脉压(MPAP)、氧合指数(OI)。结果研究组患者面色转红润41例占95.35%、肝脏回缩41例占95.35%、哺乳时间缩短40例占93.02%、湿啰音消失41例占95.35%、烦躁消失39例占90.70%,显著高于对照组,差异有统计学意义(P<0.05);两组患者病原菌检测共检测出147株病原菌,其中检测出革兰阴性菌86株,占58.50%,革兰阳性菌53株,占36.05%,真菌8株,占5.45%;治疗后,研究组LVSF、LVEF、E/A、SAP水平高于对照组,LVDD、LVSD、MPAP、OI等低于对照组,差异有统计学意义(P<0.05),研究组患者治疗有效率为95.35%,对照组患者治疗有效率为81.40%,显著低于研究组,差异有统计学意义(P<0.05)。结论米力农雾化疗法能够显著缩短重症肺部感染并发心力衰竭儿童体征症状改善时间,有效改善其心功能,提高治疗有效率,且具有较好的安全性,值得临床推广。

OBJECTIVE To investigate the application effect of milrinone nebulization in the treatment of children with severe pulmonary infections complicated with heart failure,so as to provide a theoretical basis for clinical treatment.METHODS From Jun.2013 to Jun.2016,86 children with severe pulmonary infections complicated with heart failure were selected in our hospital.According to the random number table method,the children were divided into study group and control group,with 43 cases in each group.Patients in control group were given basic treatment,and in study group were given milrinone nebulization therapy on the basis of control group.The heart rate,ruddy complexion,mental state,lung rales disappear time,lactation time,liver contraction time and other signs between the two groups of children before and after treatment were observed.The symptoms and signs and the effective rate of treatment of the two groups were compared.The side effects of the drugs in the two groups were observed and recorded.LVSD,LVDD,E/A,LVSF,SAP,MPAP,and OI of the two groups were measured.RESULTS In study group,there were 41 cases of rosy complexion,accounting for 95.35%,41 cases of liver retraction,accounting for 95.35%,40 cases of shortened lactation time,accounting for 93.02%,41 cases with wet rales disappeared,accounting for 95.35%,and 39 cases with irritability disappeared,accounting for 90.70%,which were significantly higher than those of control group（P〈0.05）.There were 147 strains of pathogenic bacteria detected in the two groups,including 86 strains of gram-negative bacteria,accounting for 58.50%,53 strains of gram-positive bacteria,accounted for 36.05%,and 8 strains of fungi,accounting for 5.44%.After treatment,the levels of LVSF,LVEF,E/A and SAP in study group were higher than those in control group,LVDD,LVSD,MPAP,and OI were lower than those in control group,and the differences were significant（P〈0.05）.The effective rate of study group was 95.35%,which was significantly higher than 81.40% of control group（P〈0.05）.CONCLUSION Milrinone nebulization therapy can significantly shorten the improvement time of signs and symptoms in children with severe pulmonary infections complicated with heart failure,effectively improve cardiac function,improve the treatment efficiency,and has good safety,which is worthy of clinical promotion.